The Care Quality Commission has found some improvements in services for older people in York.
CQC has published a report on progress made since a local system review of York that was published last year. The review looked specifically at how people move through the health and social care system, with a focus on how hospitals, community health services, GP practices, care homes and homecare agencies work together.
The original review in November 2017 found that the system should continue to develop strong relationships to address the lack of collaboration and trust between system leaders and develop a wider system vision for prioritising actions and specifying accountabilities and shared governance arrangements, to prevent duplication. There also needed to be a system-wide response to effectively manage the social care market and domiciliary care.
During the Progress Review in November 2018 CQC found that relationships between system leaders had improved but there was still work to do to increase collaboration between system leaders and embed true system working.
The review noted improved relationships between system leaders - there was evidence of stronger partnership working at operational level. The system was focused on implementing high impact changes for managing transfers of care and there was evidence that multi-disciplinary working around individual people’s needs. This was more common in York than it had been before.
The system had established a Place Based Improvement Partnership which had brought together system leaders from across health and care, as well as the Voluntary, Community and Social Enterprise (VCSE) sector and the Police.
Engagement with independent care providers had also improved. Commissioners had introduced forums for providers across health and social care to come together and meet with system. The Independent Care Group for North Yorkshire and York had been given a seat on the Health and Wellbeing Board
Alison Holbourn, Deputy Chief Inspector of Primary Care Services and Integrated Care, said:
“While a number of key relationships across York had improved, we found that there were still relationships that required significant development. System leaders had established a Place Based Improvement Partnership, which brought together system leaders from across health and social care, as well as the Voluntary, Community and Social Enterprise (VCSE) sector and the Police. However, there was still work to do for system partners to come together regarding the joint commissioning of services to meet future need.
“The 2017 review found that the CCG’s financial position was creating a barrier to partnership working, we detected tensions between the trust and CCG. At the time of our review there was still not a shared understanding of the total financial resource available for planning for winter 2018/19 and tensions in some relationships were still evident.
“More positively we found that since our Local System Review in October/November 2017 the system had improved the way that it communicates with the people of York. The system had launched the Live Well York website, a comprehensive hub of information.
“The system still had some way to go to implement seven-day services across the system and while progress was being made in some areas the pace of this progress was slow. System leaders should continue to focus on developing relationships and partnership working across the system.”
CQC will present its findings to the health and social care system leaders in York so they can continue to work together and focus their efforts to improve the delivery of joined up care for all people living in the city.
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While a number of key relationships across York had improved, we found that there were still relationships that required significant development.
Alison Holbourn, Deputy Chief Inspector of Primary Care Services and Integrated Care