To consider the attached paper on out of hospital care, including Continuing Healthcare, discharge pathway and self-funders, and to determine any recommendations the committee wishes to make.

The committee considered the report by the acting director for adults and communities and NHS Herefordshire and Worcestershire CCG. The report was introduced by associate director of nursing and quality Hereford and Worcestershire CCG and the acting director for adults and communities Herefordshire Council.

During the debate the committee raised the following principal points:

·         Disappointment was expressed regarding the outstanding responses to recommendations agreed by the committee dating back to 2018. All outstanding recommendations would be combined and forwarded to relevant partner organisations for a response. In particular an update on the status of the NHS England review into continuing Healthcare eligibility was sought.

·         A further report would be brought to the November meeting of the committee with updates on the outstanding recommendations and when more substantive detail could be reported.

·         As the expected report was not available, the Committee focussed on Continuing Healthcare (CHC).

·         The impact on Hospital discharges of residents from Wales at local hospitals was raised and the discharge of Herefordshire patients from Welsh hospitals.

·         The involvement of the voluntary sector in Continuing Healthcare (CHC) arrangements was raised.

·         Outstanding CHC dispute cases in Herefordshire were raised and the current delays to resolving such cases.

·         It was requested that details of the end to end stakeholder review was shared with the committee when available.

·         The importance of ensuring that the service remained person-centred and avoided an excessive emphasis on internal process was highlighted. Such a person-centred approach should be reflected in training programmes and materials.

The recommendations below were proposed and seconded and carried unanimously.

The committee recommends:

that the council and CCG work together to provide a more substantive report to the committee at a time when a greater level of detail on progress can be reported.

that those recommendations previously agreed by scrutiny from 2018 and 2020, and identified in the report, are properly considered by relevant bodies and responses provided.

that detail concerning the number and age of outstanding CHC dispute cases in Herefordshire are provided to the committee.   

that an update on the status of the NHS England review into CHC eligibility is provided to the committee.