Bradford's health and social care system reviewed in new report

Its report is one of 20 targeted reviews of local authority areas looking specifically at how people move through the health and social care system, with a focus on how services work together.

The reviews look at how hospitals, community health services, GP practices, care homes and homecare agencies work together to provide seamless care for older people living in a local area.

The health watchdog's report found there was a clear shared and agreed purpose, vision and strategy described in the Happy, Healthy at Home plan which had been developed by the organisations that make up the system in Bradford.

The CQC said this was articulated throughout all levels.

Inspectors found that most staff were committed to the vision - whether working in adult social care, primary and secondary care sectors, or in the voluntary sector.

They also said different agencies were working together in an effort to keep older people safe at home rather than hospital, where possible, and help them move between services when that was necessary.

The report outlined that some frontline staff found the sharing of information was still an occasional barrier, but inspectors found that some of the information sharing processes were well developed.

They said there were clear advantages where GPs and one of the acute NHS hospital trust had a shared IT system.

However, access to GPs and district nurses was variable, especially out of hours. Homecare agencies reported that in some areas people had to rely on the emergency services because they could not get a GP or district nurse to attend in person.

The report also said the quality of domiciliary care, residential and nursing home care services in Bradford was poorer than other areas.

As of December 2017, less than half of the nursing care homes in Bradford that had received a CQC rating had been rated as good compared to 59 per cent across comparator areas and 62 per cent nationally.

And for residential services, 48 per cent were rated as good compared to 72 per cent across comparator areas and an England average of 75 per cent.

The report said leaders need to ensure that staff in health services and independent social care provider services have a better understanding of people’s rights and are able to understand the lifestyle choices that people make.

Other areas for improvement include addressing issues around quality in the independent social care market, clearer signposting, as well as medicine management when people leave hospital.

Professor Steve Field, Chief Inspector of Primary Care Services, said: “It is encouraging to report that we have seen many positive aspects to the Bradford strategic plan. It is clear that all the main agencies have bought in to the partnership, with some positive results to show for it.

“We found some good joined up interagency processes, particularly the Bradford Enablement Support Team and the multi-agency integrated discharge team. The medicines service at home service is another example of innovative practice.

"Partnership working is an essential component of these initiatives.

“The public health team was focused on promoting the health and independence of people so that they can remain at home. They were maximising opportunities around housing, recognising that people have very different needs and so looking at ways to meet these.

“There are areas that the local system knows it must now focus on to improve further. But a lot of work has gone in to forming and developing relationship which is already producing better outcomes. Bradford has made a very good start.”

Councillor Sarah Ferriby, Portfolio Holder for Health and Wellbeing at Bradford Council, added: “I am delighted that the CQC recognised the strength of local partnership working and the commitment of health and care teams to our clear shared vision for people to be ‘Happy, Healthy and at Home’. Bradford has been highlighted through the review as having good practice and providing service users with the support and advice needed in their care.

“Working together in partnership with all our agencies and building on those relationships is crucial for us all going forward so we are able to continue to improve our support and care to those that need it the most across the district.

“I want to thank staff for all the work they do to achieve such good results. Staff are working really hard across the spectrum of health and care.

"We all know that we still have lots more to do in improving services so its helpful to have the findings from the review so that we can continue to serve people better.”