Isle of Wight Dementia Patients: Discharge to Mainland Care Homes
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The Parliamentary Under-Secretary of State for Health and Social Care (Preet Kaur Gill)
I am grateful to my hon. Friend the Member for Isle of Wight West (Richard Quigley) for raising this very important issue, and I recognise the deeply concerning experiences that he has highlighted of families on the Isle of Wight, including the story of Maggie Bennett and the café that she runs.
For people living with dementia or complex disabilities, being moved away from their homes and loved ones can be profoundly distressing. Familiar surroundings, routines and relationships are often central to their wellbeing, and it is entirely understandable that families feel anxious when those links are disrupted. The Government are clear that people should be discharged from hospital safely, promptly and with appropriate care and support in place. This is essential not only for patient outcomes but to ensure that hospitals can continue to treat those in greatest need.
Local authorities have a statutory duty under the Care Act 2014 to shape their local care markets, ensuring that there is a sufficient range of high-quality, person-centred services available to meet local needs. Decisions about care placements are made at a local level based on clinical need, the suitability of available services and the individual’s circumstances. Where a person requires specialist or higher-intensity support, it is essential that the placement meets those needs in full.
However, I do recognise that local capacity pressures, particularly in geographically isolated areas such as the Isle of Wight, can mean that suitable placements are not always immediately available. My hon. Friend spoke about the impact of care home closures in his constituency and shared Phyllis’s story. While temporary placements further away are necessary to ensure that a person is discharged safely and without delay, those situations clearly have a huge impact on families.
On the Isle of Wight, local partners are working to improve access to more seamless pathways across health and social care so that people can move more easily between services and receive the support that they need. This includes strengthening co-ordination and expanding care in the community so that wherever possible people can be supported at home or close to home. As my hon. Friend said, because of the island’s size and physical isolation, that also requires close working with mainland partners to ensure that residents can access the full range of care that they need, including specialist provision where it is not available locally.
We will continue to explore and build on opportunities to deliver services for the benefit of the Isle of Wight community so that care can be delivered at the right place at the right time. We expect local systems to plan for demand and work with providers to strengthen capacity, including for people with dementia and complex conditions.
As we heard from my hon. Friend, it is vital that when a difficult decision is made to close a care home, the process is handled as sensitively as possible. Local authorities should have procedures in place to minimise disruption, with time allowed to support a safe transfer that supports the wellbeing of individuals, families and carers. Providers should ensure that proper arrangements are in place to support the transition of residents to their new position. Our expectation is that every effort should be made to provide care as close to home as possible and to take account of family connections and personal preferences wherever practicable. It is also essential that individuals and their families are involved in decisions about discharge and ongoing care. The guidance is clear that planning should begin early and that patients and carers should be supported to make fully informed decisions where appropriate.
We know that people who are discharged in a timely way with the right care and support in place experience better recovery and health outcomes. That is why we expect local systems to work together to ensure discharge processes are as effective as possible, particularly for people with dementia and other complex needs. The Government are therefore working with the NHS and local authorities to strengthen the local health and care system so that it can better meet those challenges.
Through the better care fund, more than £9 billion is being used to support integrated working between the NHS and local authorities, enabling more joined-up services and improving the planning of care outside of hospital. We will also reform the better care fund to support more effective joint planning and delivery between health and social care. That will be focused on improving how services are co-ordinated and supporting care that helps people regain their independence, reduces unnecessary hospital stays and enables people to receive care closer to home.
We also recognise the importance of improving care and support for people living with dementia. According to NHS data, NHS Hampshire and Isle of Wight integrated care board recorded that as of March more than 18,000 people had a diagnosed form of dementia. The Government want a society where individuals with dementia and frailty receive high-quality, compassionate care from diagnosis through to the end of life. That is why we will deliver the first ever modern service framework for frailty and dementia to deliver rapid and significant improvements in the quality of care and productivity. That will be informed by phase one of Baroness Casey’s independent commission into adult social care, which is under way and expected later this year.
We are committed to feeding into the NHS and local government planning cycles in September and aim to publish the full framework by the end the year, as recommended by Baroness Casey. We intend to engage with a range of partners over the coming months and will ensure that the voices of people with lived experience are at the centre of our work to develop the modern service framework.
I thank my hon. Friend for bringing his constituents’ voice to the House. I reiterate that we recognise the very real concerns raised by families on the Isle of Wight, particularly when people with dementia or complex needs have been moved away from their homes and communities. While there will be circumstances where temporary placements further from home are necessary, care should be provided as close to home as possible in a way that respects the individual’s needs, preferences and connections to their family and community.
Madam Deputy Speaker (Ms Nusrat Ghani)
I did not have time to congratulate the Minister, a fellow Brummie, on her promotion. It is good to see those from Birmingham here in the Chamber.
Question put and agreed to.