Dorothy House Hospice Care welcomes Philip Hammond’s announcement in the Spring Budget of a further investment of £2bn in social care and the Better Care Fund of which £1bn will be available from this April. A recent report by the National Audit Office (February 2017) criticised the fund for failing to decrease both the expenditure in the acute trusts or amount of bed days for people who were “medically fit for discharge.” 
That has not been our experience over the past two years. Using the “Better Care Fund” as an enabler, we have already partnered successfully this past year with the Royal United Hospital Bath Wiltshire Clinical Commissioning Group and Wiltshire Council to run an Enhanced Discharge Service aimed at getting end of life care patients out of hospital quickly following urgent care. 
We are also in talks with B&NES and Somerset CCGs to roll this service out to other areas. The holy grail is to create a funded and similarly responsive model to avoid unnecessary hospital admissions. Having a robust social care platform (Better Care Funded) will, if there is the investment, enable this to be introduced with significant impact both in terms of the quality of patient care and economic efficiencies.
The Enhanced Discharge Service already had a significant impact on many patients’ ability to achieve a rapid discharge from hospital and to die in the place of their choice. In the first six months of the project 26 patients were supported, saving 372 bed days, which represents a saving to the system of £148,800.
It’s critical for onward investment that Dorothy House Hospice Care, in partnership with Health and Social care services, is able to demonstrate real efficiencies whilst also improving the care and experience of the patient their families and carers. Recent voluntary and regulatory scrutiny of the hospice, first by HealthWatch Wiltshire and then by the Care Quality Commission demonstrates the outstanding impact and value of the Enhanced Discharge Service and Hospice At Home services we provide.
While more funds are always needed, this Budget’s investment in social care is the right decision by the Government and creates real opportunity if grasped fully.
Wayne de Leeuw,
Executive Clinical Lead
Dorothy House Hospice Care
Winsley, Nr Bradford on Avon