This report from the Nuffield Trust explores the actions and strategies that providers and commissioners have put in place to improve the interface between secondary and social care, with a focus on what hospitals can do.
The health and social care sectors are dependent on one another to succeed. But the boundary – or interface – between the two is challenged daily: care received in one of the sectors has a direct impact on the other. This report focuses on that interface.
Now more than ever before, hospitals are struggling to meet performance targets. Delayed transfers of care increased by 185,000 in 2015/16 compared with 2014/15 – costing a total of £146 million more than planned (National Audit Office, 2017). By the third quarter of 2016/17, just 82% of patients attending Accident & Emergency (A&E) departments were seen, treated and admitted or discharged within four hours (National Audit Office, 2017) – the worst performance since the target was introduced in 2004.
Hospitals are increasingly blaming their local social care sector for playing a part in their deteriorating performance and tensions are rising at a time when collaboration between the two sectors is needed more than ever before.
This report explores the actions and strategies that providers and commissioners have put in place to improve the interface between secondary and social care, with a focus on what hospitals can do. In particular, we look at:
- collaboration to prevent avoidable hospital admissions
- the interface between hospitals and social care providers when patients are discharged from hospital
- the relationship between commissioners and social care providers
- wholescale organisational integration.
Drawing on the experience of seven case study sites, as well as evidence of what has worked to date, we make five recommendations for national policy-makers. We also make seven recommendations for local hospital leaders.