"No magic bullet" - Healthwatch CEO says co-ordinated response needed for health and social care
The Chief Executive of Healthwatch Cornwall has been speaking amid the health and social care crisis
The chief executive of Healthwatch Cornwall says that there needs to be a co-ordinated response to the current crisis in health and social care in Cornwall. Mario Dunn said that more and more people are contacting the organisation to report problems with accessing healthcare.
There have been multiple reports and regular photos of queues of ambulances at Cornwall’s main Royal Cornwall Hospital amid problems with discharging people after treatment which has caused blockages with getting people into hospital.
Hundreds of people who are medically fit to return home have been unable to be discharged as there has been a lack of care packages available to ensure that people can go home safely.
Healthwatch Cornwall is a health and social care champion giving people the chance to give their feedback on health and social care provision in Cornwall and passing those comments on to the NHS and Cornwall Council. As an independent organisation it has powers to make sure the NHS takes on board any feedback and carries out improvements when required.
Mr Dunn said that the comments being passed to Healthwatch Cornwall were familiar to those in health and social care: “The responses we are getting are the same as the NHS and Cornwall Council are getting. People are struggling to get into hospital when they call an ambulance.
“The delays in ambulance response times are getting longer and longer and once an ambulance arrives at the emergency department at Royal Cornwall Hospital delays in handover can be very long, several hours.
“The principal reason for this is the NHS has people in hospital beds in Cornwall who shouldn’t be in them. They need to be discharged but they don’t have a care package for them once they leave due to a shortage of care home staff and beds and services which mean they have to remain in hospital.”
Mr Dunn said that it was a big challenge for the health and social care sector but one for which there was not one “magic bullet” solution.
He said: “It is not just about money, it is about recruiting, attracting and retaining people in social care in Cornwall. However it goes beyond that, if you are going to encourage someone to work in Cornwall they need somewhere to live and that is a big problem in every sector right now.”
Some Cornwall councillors were recently suggesting that rates of pay for care staff should be increased to help attract more people to the actor, would that help? “It is an answer, and one of many, but whether or not that is possible is a question for the council which is running a large financial deficit.”
There have been concerns that with health services in crisis people might fear whether they will be able to get the help they need if they become poorly or that they might not seek help for fear of adding to the issues.
Mr Dunn said: “There is a danger of that, people are concerned about the condition of the NHS and not just for that reason. We are witnessing long waits for treatment and people are concerned about whether the NHS has the capacity to respond to their needs.
“However, what is important is that people use the NHS properly, for example not to dial 999 for issues that do not need an emergency response. People should dial 111 or go to their GP rather than go to the emergency department.”
Cornwall Council has suggested that one way of enabling people to be able to go back to their own homes to recover after being in hospital is for people to look after their neighbours and family when they return home.
Mr Dunn said that “the system can’t rely on volunteerism in that way to fill the gaps” but he did say that the voluntary sector of organisations and charities in Cornwall could be a way of boosting the capacity for caring.
He said: “They must be considered to be part of the system and part of the health resources to deliver services at that local level. That is not the situation at the moment, not just in Cornwall, but elsewhere as well.”
However, he admitted that was changing and that the new Integrated Care System in Cornwall would be creating links between health, social care and the voluntary sector. But he said that it would take time for that to become embedded so that it can become part of the solution to current problems.
“Everything takes time, it is a juggernaut, an oil tanker rather than a speedboat and it will take more than months, probably years, to change the structure to make it more responsive and more efficient.”
The Healthwatch boss said that there was a need for a more joined up approach amongst all agencies and organisations in Cornwall to try and find a way to improve the current situation. This would involve everyone involved in all the different aspects – from the NHS and housing services to the council and education and training providers – creating a whole picture view of what could be done to help.
Mr Dunn said: “It is a package of measures, some are achievable and some are big ticket items which will take time. The new integrated system is supposed to be there to link up the organisations and bodies that are responsible for those different aspects so they can work together.”
He added: “I will be honest, it is a good process in how to identify the challenges and what solutions there might be but, ultimately, the same problem will always be there about resources and councils being able to do everything they want to do.”
The chief executive said that the health and care sector was now waiting to see what the new Chancellor will do in terms of spending on the NHS and local councils and whether there will be any impact from the expected cuts in spending which he admitted “it is not going to be good”.