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The Care Quality Commission has published its findings following a review of health and social care in Trafford, Greater Manchester.
This report is one of 20 targeted local system reviews looking specifically at how 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.
CQC found that there was system-wide commitment to serve the people of Trafford well. Trafford Council and NHS Trafford Clinical Commissioning Group are due to become fully integrated as commissioners, sharing responsibility for a new model of integrated services which come into effect in April 2018.
The challenge for Trafford was to transform services while delivering improvements, as the experience of people receiving health and social care was varied.
- While there had been some significant improvements in performance over the past year, it was from a low starting point and the system’s ability to cope with surges in demand was uncertain.
- If a person needed urgent care, they were likely to be admitted to hospital and experience longer stays in hospital due to a shortage of services that would look after their needs when they return home.
- Systems and services were in place to support people as they prepared to come out of hospital but there was insufficient capacity in homecare services to meet demand.
- GP access varied across the borough and information and support was not always easily accessible.
- If a person received a re-ablement service they were more likely to remain independent, at home and in better health. However, there were missed opportunities to support people to stay in their usual place of residence and prevent admissions to hospital.
- In the first quarter of 2016, A&E attendances and emergency admissions from care homes were higher than average. Although more recent figures were better than the national average – the actual number of admissions had not fallen. People were being admitted with conditions that could potentially be cared for in the community, such as urinary tract infections.
Professor Steve Field, Chief Inspector of General Practice, said:
"It is clear there is a real commitment by organisations working across Trafford, to transform and integrate services. Trafford is a lot further on in their integration journey than others, thanks in part to Greater Manchester devolution and the shared vision set out in the Trafford transformation bid."
“However, leading organisations in the health and social care system, including Trafford Council and NHS Trafford Clinical Commissioning Group, need to ensure people are receiving a better service during these improvement works."
“This review tells us that there are missed opportunities to support people where they live, with too many ending up in hospital unnecessarily. We also found that people in Trafford often stay longer than they should, due to a shortage of homecare packages and affordable, high-quality residential care."
“Our team found that operation staff were willing and enthusiastic about change and doing the right thing for people, but people’s individual needs could be better catered for."
“The reorganisation of the system in Greater Manchester provides a unique opportunity to transform the health and social care landscape… we will know that is paying off when all providers in Trafford – whether NHS, primary care or social care - are working together effectively to help people remain living at home, and out of hospital unless it is absolutely necessary.”
For further information please contact CQC Regional Engagement Officer Kerri James by email email@example.com or by phone on 07464 92 9966.
Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here.
Please note: the press office is unable to advise members of the public on health or social care matters. For general enquiries, please call 03000 61 61 61.
- Last updated:
- 18 December 2017
Notes to editors
The Trafford local system review looked principally at how people move between services provided by 63 care homes, 36 homecare agencies, 32 GP practices, Central Manchester University Hospitals NHS Foundation Trust, and University Hospital of South Manchester NHS Foundation Trust. These two trusts recently merged to create Manchester University NHS Foundation Trust.
This review was carried out following a request from the Secretaries of State for Health and Communities and Local Government to undertake a programme of 20 targeted reviews of local authority areas. The purpose of the reviews is to understand how people move through the health and social care system with a focus on the interfaces between services, and identify any areas for improvement.
This review makes a number of suggestions of areas for the local system to focus on to secure improvement including:
- During winter the system should remain focused on current provision of services to ensure improvements in performance are sustained while delivering transformational change.
- The whole system should work together to manage the social care market and domiciliary care capacity to ensure that there is enough to meet demand.
- Admission criteria to intermediate care services should be reviewed to ensure consistency and effectiveness of service provision. Acute hospital staff should be engaged in the evaluation process.
- System leaders should ensure there is an approach to workforce planning that identifies current and future needs in alignment with the Greater Manchester workforce strategy.
- Work is required to share learning and experience between staff at the point that health and social care services meet so there is shared trust and understanding that breaks down historic barriers.
- There should be a joined-up, coordinated response to engaging with the voluntary sector and provider organisations as system partners