The Care Quality Commission has published the findings of a report looking at how health and social care systems in Liverpool are working together to care for people aged 65 and older.
The review, carried out in February, included interviews with those involved in leading and shaping services, reviewed care and treatment records and visited 14 services in the area.
Although there is no overall grading, the CQC found that there is a clear strategic direction for services, with a commitment to work with wider partners and evidence of strong collaborative working in some parts of the city.
Staff were found to be committed, energetic and passionate about delivering high quality care.
However, the experiences of people using health and social care services varied. People were not always seen in the right place, at the right time by the right person and there were inconsistencies in commissioning and provision of services.
Efforts to cut the bureaucracy in discharging patients from hospital had led to some improvements in delayed transfers of care. They also noted that partners had learned how to build resilience for services at times when there is most demand, such as over winter, but that more work is required to reduce the pressure on emergency departments.
The report highlighted areas of the Trust that were improving care for patients aged 65 and older.
"The Day Ward at Broadgreen Hospital was described by one carer as ‘The NHS at its best.’"
It highlighted the Day Ward at Broadgreen Hospital with a range of clinics including falls to dementia, where staff worked effectively with community partners to support patients outside hospital. This was described by one carer as ‘The NHS at its best.’
The care provided on the Frailty Unit and the system behind this was was highlighted as an area of good practice. Located besides the emergency department, the Unit provides rapid assessment and treatment to frail elderly patients aimed at getting them medically fit as soon as possible to avoid staying in hospital any longer than necessary.
A number of partnership working programs were also cited as having a positive impact on the delivery of patient care. These included the work of the A&E Delivery Board, praised for how organisations worked to support one another during a challenging winter and the Integrated Community Reablement and Assessment Service (ICRAS), which has helped to provide support for patients being discharged from hospital more efficiently.
The work underway to establish shared electronic patient records with local partners was also cited as a positive way forward.
The CQC report makes a number of recommendations that the Trust and its partners will be assessing. These include:
- Transforming the strategic vision for the city into an operational plan which is system wide
- Strengthening relationships to ensure effective partnership working
- Developing a comprehensive public engagement strategy
- Strengthening system-level governance arrangements to address performance and quality issues
- Support more people to access personal budgets and direct payments
- Improve information flows between services