Beth y mae Llywodraeth Cymru yn ei wneud i wella gwaith cynllunio rhyddhau cleifion a llif cleifion yn ardal Bwrdd Iechyd Prifysgol Hywel Dda?
We introduced the Pathways of Care Delays (PoCD) framework in April 2023. It provides the NHS and social care with a comprehensive and consistent dataset about discharge delays so relevant interventions and actions can be appropriately targeted. Monthly data are published Pathway of Care Delays by reason for delay and date (gov.wales) under an extensive set of reason codes, broken down to health board and local authority level, providing a clear oversight of the position across Wales.
The health and social care Regional Integration Fund (RIF) provides £146m every year to March 2027 to Regional Partnership Boards (RPB) to establish and mainstream six new national models of integrated care:
- Community based care – prevention and community coordination
- Community based care – complex care closer to home
- Promoting good emotional health and well-being
- Supporting families to stay together safely, and therapeutic support for care experienced children
- Home from hospital
- Accommodation based solutions
The West Wales region is funding 10 projects aligned to the home from hospital model of care (£6.5m) to support hospital discharge processes and to manage patient flow. The projects range from admission avoidance, complex care planning through to reablement provision and projects where the third sector is playing a crucial role in enabling people to leave hospital when they are clinically fit to do so.
For example, PIVOT, which predominantly supports older people and people living with dementia across Pembrokeshire, is a partnership between five third sector organisations that provide pre-hospital/hospital/post hospital support services. Care and Repair, which is in the second year of the RIF, saved 1,074 bed days through its proactive fast track approach to install aids and adaptations to enable people to return home.
The Six Goals for Urgent and Emergency Care programme includes a specific focus on supporting health boards, RPBs and local authorities to improve patient flow. The local Six Goals programme in the Hywel Dda University Health Board are is using a robust digital platform to phase implementation of the national Optimal Hospital Patient Flow framework. This will enable discharge planning to be quickly captured and shared with services, reducing duplication and referral delays.