Nottingham’s NHS and care services say they are in a strong position to cope with serious added pressures and demand for hospital beds this winter.
Each year council care planners and medics work together to predict how they can best ensure hospitals can keep working effectively during colder weather.
The period is know for a significant rise in demand on the NHS as older and more vulnerable people are more likely to fall seriously ill with conditions such as flu, Covid, and other respiratory problems.
This can create serious backlogs in hospitals if patients fit for discharge cannot find space in the care system if they are unable to look after themselves at home, meaning they can end up staying longer in hospital even though they are well and ready to leave.
At one point last winter more than 170 Nottingham patients fit for discharge were left stuck in hospital because there was no appropriate place for them to go to.
Every year Nottingham City Council uses a winter plan to support adult social care services during a “period of particularly high pressure”.
The issue was discussed at the council’s health and adult social care committee on October 12.
Richard Groves, head of service for access and prevention at Nottingham City Council, explained how the council and NHS had implemented new measures in the last year to combat the problem.
Mr Groves said that this time last year, the service was using 40 ‘interim beds’ from Nottingham City Homes for patients who could not be transferred from hospital to home straight away.
At the moment, he said only 10 interim beds are being used.
Council papers stated its social care workforce has also seen a lower turnover rate as a result of a new pay and progression model.
The turnover rate for social workers has improved from 22.73 per cent in 21/22 to 10.91 per cent in 22/23.
Mr Groves added: “We are in a very positive position going into winter this year. We have seen significant improvements in terms of discharge and social care enablement.
“We were seeing significant waits for that service with 177 people waiting in September 2022. The numbers have remained in single figures now since March this year.
“That’s attributed to work we’ve done around discharge through the Better Care Fund to increase capacity within the homecare market.
“In terms of this year’s winter plan, we continue to have regular system meetings with health colleagues.
“We brought in additional contracts to support homecare and we will continue to do that this winter.”
He added that the service is part of the ‘Transfer of Care Hub’ which was originally piloted last year.
It enables ‘most’ people to be transferred from hospital to a home setting within 24 hours.
Mr Groves added: “We do still see high levels of pressure in terms of hospital admissions.
“This is unfortunately impacted by strike action. I believe we haven’t ever really come out of winter pressures.
“We are seeing high demands for adult social care, which are reflective of the national picture.”
Cllr Linda Woodings (Lab), Portfolio Holder for Adult Social Care, said the council started to use non-accredited homecare companies so more patients could be discharged from hospital.
This refers to an accreditation process Nottingham City Council has for homecare providers who are already registered with the Care Quality Commission (CQC).
Cllr Woodings said: “Some of those providers are now gaining accreditation.
“We took a bit of a risk because we had delays which were stopping people coming out of hospital.
“We widened our supply and did additional quality checks on the work they were doing.”
Cllr Woodings added: “I want to praise Richard and his team for the job they did.
“At one stage last winter 177 people were in the queue to come out of hospital.
“They have worked tirelessly and now we have been in single figures for a long period of time now.
“We got extra funding last winter from the government to help us.
“We feel we’re in a better position this year than we were last year.”
Gemma Whysall system delivery director urgent care ICB, added that a ‘system control centre’ has been established ahead of this winter.
She said: “We are trying to look at live data all the time to make sure we are matching demand and capacity across the health and care system.”