Between January and October 2012, Surrey County Council worked closely with health partners to introduce reliable seven days per week social care services, including earlier weekday mornings and later evenings. This example of a local initiative forms part of our managing transfers of care resource.
In 2011 there was growing pressure for change across the whole system of health and social care.
Feedback from residents and the Surrey LINk suggested there was significant demand for weekend and weekday evening services. At the same time, there was national concern about the quality of out-of-hours care in hospitals, and Surrey’s hospitals were experiencing growing pressure on their bed capacity.
Between January and October 2012, Surrey County Council worked closely with health partners to introduce reliable seven days per week social care services, including earlier weekday mornings and later evenings.
Key underpinning principles between Surrey County Council and the five hospital trusts included:
- joint commitment to improving outcomes
- senior leadership and sponsorship from all partners
- shared investment of resources
- flexible local arrangements within a countywide framework
- co-design with staff doing the work
- practical, integrated working arrangements
- creative new ways of working together.
The increased accessibility of adult social care staff has reduced patient length of stay, freeing up much-needed hospital beds sooner. This has supported the hospital trusts to achieve their nationally defined Commissioning for Quality and Innovation (CQUIN) targets. Locating adult social care staff in A&E and medical assessment units at weekends and weekday evenings has helped to reduce the number of avoidable admissions into hospital. Patients, families, carers and health professionals can access social care information and advice seven days a week, supporting effective decision-making.
In 2017, Surrey social care teams still operate out of the five acute hospitals, and still work seven days a week, from 8am to 8pm. The positive change delivered during 2012 is bringing the Surrey health and care system long-term benefits, as this approach is now established as business as usual.
Since seven day, eight to eight working began, hospital team managers have been meeting regularly to ensure consistent approaches and best practice across all sites providing a hospital social work service.
They have used these sessions to:
- understand and follow national guidance and drivers
- undertake comparative learning and sharing of Surrey approaches to collaborative working and integration in relation to hospital discharge (and wider).
There has been benefit to the workforce in that they have been able to develop consistent practice across all of the acute hospital sites. Additionally hospital team managers have been able to use peer manager relationships to achieve solutions to practice challenges.
Looking at DTOC (total attributable) by Surrey hospitals over the past seven years, DTOC days have increased by 62 per cent in total across England but have reduced by 17 per cent in Surrey. Between 2010/11 and 2011/12, Surrey’s performance was behind the England average. With action taken across the system since then, including the implementation of 8am to 8pm working seven days a week, has enabled Surrey to outperform the England average.
Contact
Andre Lotz
Project Manager
Health and Care Integration
Surrey County Council
[email protected]