Health inspectors say there has been a “significant improvement” in how public sector organisations work together to provide services for older people who need care in Stoke-on-Trent.
The Care Quality Commission (CQC) has revisited the city to look at how well older people – and specifically those over 65 – can move through the health and social care system following an initial inspection in September 2017.
The review, which took place on November 21 and 22 last year, looked at progress made since an action plan was submitted in 2017 between organisations including Stoke-on-Trent City Council, Stoke-on-Trent Clinical Commissioning Group (CCG), the North Staffordshire Combined Healthcare NHS Trust, the University Hospitals of North Midlands NHS Trust (UHNM), the Health and Wellbeing Board and the Midlands Partnership Foundation Trust (MPFT). It focused on how services including GPs, care homes, hospitals, health commissioners and the local authority work together.
Representatives from Healthwatch Stoke-on-Trent, as well as voluntary and community sector services were also interviewed by the CQC, alongside service users.
The review found an improvement in relationships and joint working towards shared goals, “a collaborative approach and culture was emerging”, and that system leaders – in particular Stoke-on-Trent City Council’s city director, David Sidaway – had worked hard to engage and lead the required change agenda.
Inspectors also said the appointment of a new director of adult social care and a managing director for the local CCG, coupled with strong leadership and support from the Staffordshire Sustainability and Transformation Plan (STP), were having a positive impact on both planning and performance.
The report, which is published today, says: “Greater transparency between leaders meant that they could address barriers jointly which was leading to improved outcomes for people. This was mirrored by operational staff across the CCG and the local authority who, within the new organisational culture, were enabled and empowered to develop solutions together.”
It also highlighted an improvement in the quality of care in the independent social care market and how commissioners worked with providers. It was noted that planning for winter 2018/19 had been done jointly between all partners and had been developed around evidence-based learning. The report added: “System leaders had analysed and evaluated previous winter pressures and worked together to put a robust plan in place.”
Councillor Ann James, leader of Stoke-on-Trent City Council and cabinet member for health and social care, said: “We very much welcome the findings of this review, which highlights the efforts we have made to improve services for older people in the city.
“Alongside our partners in health and social care, we have worked hard to ensure we are taking a joined up, collaborative approach in order to provide seamless care for people aged 65 and over. My thanks go to everyone who has enabled this to happen.”
The review also made a number of suggestions of areas for the local system to make further improvements, including making sure the voluntary, community and social enterprise (VCSE) sector is more involved, and making integration across health and social care a priority.
Councillor James added: “While we are delighted with the progress being made, it doesn’t end here. We will continue to make sure we take all the necessary steps – including those identified in the review – to deliver the right care, in the right way and at the right time for our residents.”
Diane Lea, chair of the Stoke-on-Trent Health and Wellbeing board, said: “It is extremely pleasing to see the real positivity from the CQC about the progress that’s been made in the city. This is a true reflection of the leadership and integrated approach to partnership working that has been shown over the past 12 months.
“While the review rightly recognises more work needs to be done, it shows clearly we are going in the right direction. The Stoke-on-Trent Health and Wellbeing Board is committed to building on this work and ensuring we continue to make the progress we need for the people of the city.”
Paula Clark, UHNM chief executive, said: “We are pleased that the latest CQC report has recognised that there has been significant improvement in collaboration and relationships with the health and social care leaders. We accept that there are still areas for improvement, which we are all working hard together to progress.
“Collectively, over the past year, UHNM and our partners have developed a strong and robust plan in preparation for winter pressures ensuring that there is enough capacity in our hospitals and community. This can already been seen at both our hospitals and particularly at Royal Stoke University Hospital with flow improving considerably.
“There will be challenging times ahead but we will still continue to make improvements to provide the health and social care system that the people of Stoke-on-Trent deserve.”
Marcus Warnes, accountable officer for Stoke-on-Trent CCG and the Staffordshire CCGs said: “Our patients aged over 65 need to have confidence that those responsible for their care are working together to make it the best it can possibly be.
“This reinspection confirms that a great deal of progress has been made during the last 12 months. This demonstrates the huge amount of work that has been put in by our frontline staff. It also reflects the absolute commitment from leaders to work together to meet the very significant health challenges that exist in the city, which have been well documented over many years.
“There is still a lot to do, particularly in the way we commission services from the voluntary sector, but there have been significant tangible strides made. These include the way we are working to ensure more patients are able to go home without delay once they are fit to leave hospital, and the improvement in the standard of nursing homes.
“This process has helped us improve the way we commission services and work with our partners to make a difference to patients.”
Simon Whitehouse, director of Together We’re Better, the health and care partnership for Staffordshire and Stoke-on-Trent, said: “It’s clear from the report just how much progress has been made in a relatively short amount of time – and for this our partners, especially our staff delivering services to local people, deserve a great deal of credit and recognition.
“I’m especially pleased to see the report has emphasised the joint working and positive culture of collaboration that has led to such an improvement in services for older people living in Stoke-on-Trent.
“This report, twinned with the recent review into older peoples’ services in Staffordshire, shows we are moving in the right direction. More needs to be done, absolutely, but we now have a very firm foundation in place on which to build.”
Caroline Donovan, chief executive, North Staffordshire Combined Healthcare NHS Trust, said: “Building relationships, partnerships, alliances and joint working across the entirety of health and care partners in the NHS, local government and third sectors has been at the heart of Combined Healthcare's strategy and approach for a considerable period of time.
“I was delighted and proud to have been asked by my colleagues across the Stoke-on-Trent system to co-ordinate the development of the initial improvement plan, which underpinned our collective success and achievements in addressing the challenges identified by the CQC system review.
“It has been a real pleasure to have seen the improvements and progress we have been able to secure for local service users, their carers and families. I am confident we will now be able to build on this success and go on to even greater things.”