Same-day hospital discharge plan needs more staff to meet needs of Lancashire's elderly, claims councillor

A policy to ensure Lancashire’s elderly residents are not left in hospital any longer than they need to be will require more staff to deliver it than the county currently has available, it has been claimed.
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The government has ordered that inpatients must be discharged on the same day that they are no longer deemed to have a “reason to reside” in a hospital bed.

Lancashire adopted that principle two years ago when local authorities and the NHS introduced the Home First scheme for those people returning to their own properties following a period of ill health.

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Individuals are assessed once they have arrived back home for any care and support they may need to help them cope - replacing the previous system which saw such that process completed while they were still in hospital.

County Cllrs John Fillis and Graham GoochCounty Cllrs John Fillis and Graham Gooch
County Cllrs John Fillis and Graham Gooch

The assessments are usually carried out on the day a person is discharged - but can take up to 72 hours, during which time they receive whatever stop-gap support they require.

However, the deputy leader of the Labour opposition group on Lancashire County Council says that staff numbers should have been boosted sooner so that people’s needs are fully met from day one.

“When someone comes out of hospital, those first few days are critical,” said County Cllr John Fillis.

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“Our social care staff are doing a fantastic job - but there aren’t enough of them. The council’s own winter care plan says that we need to recruit, but it would take up to a month to get a new staff member vetted, trained and in place safely.

“So we should have had this plan three months ago to ensure these extra staff were in the pipeline.

“My concern is that the elderly people being discharged aren’t likely to complain - they will sit at home and say, ‘I’m fine, don’t worry about me’ - and the care staff will be left shooting between one door and the next because we haven’t got the people in place yet.”

The winter care plan was approved by cabinet on 5th November and notes that recruitment should be considered to maintain sufficient seasonal capacity for all social care services, which could be affected by staff absences and turnover. The county council launched a recruitment drive for adult social care specialists at the end of October.

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Cabinet member for adult services on the Conservative-run authority, Graham Gooch, accused Labour of “scaremongering to make political points" and "living in the past in social care practice”.

He added: “‘Home First’ was accepted as the best policy for assessing the social care needs of people being discharged from hospital long before we were beset by Covid.

“We have increased the support that is available to make this happen, as experience tells us people recover much better in familiar places with people they know.

“Under the national model, people should avoid remaining in hospital for any longer than they need to, which is especially important during the current Covid-19 pandemic. This also helps to ensure that hospitals have sufficient beds for people who need them more.

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“If someone is identified as potentially needing social care, then an assessment takes place in their home on the day they are discharged. This helps to understand more about their care needs, by carrying it out within their own homes.

“Any immediate social care support is started, and the person will then have a more in-depth assessment within a few days of returning home. This identifies whether they need any additional support to meet their needs.

People who are part of this Home First approach are overseen by health and social care teams, to respond to any change in circumstances and adjust any support,” said County Cllr Gooch.

Individuals can still be discharged to a care home or rehabilitation facility if they are unable to manage at home.

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