The Care Quality Commission has published its findings following a review of health and social care services in Birmingham.
This report is one of 20 targeted local system reviews looking specifically at how older people move through the health and social care system, with a focus on how services work together. The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for people aged 65 and over living in a local area.
During the review CQC sought feedback from a range of people involved in shaping and leading the system, those responsible for directly delivering care, as well as people who use services, their families and carers.
The review found there was a system-wide commitment to serving the people of Birmingham but that services had not always worked effectively together. It highlighted a number of areas where improvements are needed to ensure those responsible for providing health and social care services work better together.
Alison Holbourn, Deputy Chief Inspector of Primary Medical Services and Integrated Care, said:
“Our review of health and social care services in Birmingham found that there is a clear intent from the system’s new leadership to improve how people move through health and social care services, but the reality for people has been variable with fragmented services leading to disjointed care.
“There has not been a strong tradition of joint working in Birmingham and further work is needed to ensure that systems work in an integrated manner for Birmingham people. We found committed staff working on the frontline of services but that for improvements to be realised, a shared strategic vision must be in place to ensure people are not let down by the system.
“We have presented our findings to the new health and social care system leaders in Birmingham so that they can prioritise and continue to improve and work together in bringing joined up care to people living in the city and its surrounding areas.”
Overall CQC reviewers found:
- Peoples’ experiences of health and social care in Birmingham was variable and access and availability of services was inconsistent across the city.
- Fewer people had the chance to exercise choice and control over their care and support and some were offered care placements in parts of the city that were not accessible to their families.
- Some people were admitted to hospital with social care needs that could have been managed more effectively and safely at home and some people stayed in hospital for longer than they needed to.
- The use of community and primary care services was not being maximised through the system, but doing so could prevent people having to spend time in hospitals.
- More could be done to engage Birmingham’s diverse communities in the planning and delivery of services to ensure that services met the specific cultural and health needs of local populations.
- There was not a systematic and joined up approach across the city to using feedback from people, their families and carers, about services being provided in Birmingham.
- Recent improvements to relationships and organisational structures, while embryonic, were significant.
- For improvements to be realised at the front line, considerable work was needed to develop a shared strategic vision and drive this forward through all levels of the system building trusting relationships in an environment where challenges could be voiced safely.
This review makes a number of suggestions of areas where the local system should focus on to secure improvement including:
- The system needs to work together to develop and drive forward a shared strategic vision for the future, which reflects the needs of Birmingham’s diverse population.
- The system’s leadership needs to build on recent improvements by strengthening relationships, improving communication and ensuring there is a shared understanding among staff of their role in achieving the strategic vision at an operational level.
- The relationship between the Birmingham and Solihull Sustainability and Transformation Partnership (STP) Board and the Health and Wellbeing Board needs to be reviewed and strengthened to ensure agreement and clarity around roles and responsibilities.
- The personalisation agenda should be developed so that more people can be supported and be involved in making choices about their care, including accessing personal budgets and direct payments.
- Improving information sharing across health and social care should be prioritised, as this has proved a barrier to integrated working.
- A consistent approach to identifying high risk population groups and managing risks to people within the community should be developed across the city, and future commissioning of services should be based on these findings.
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