Agenda item

DISCHARGE TO ASSESS (D2A) PILOT

Minutes:

Report CS18068

 

The Executive considered a report which sought to obtain approval for a pilot to implement the Discharge to Assess model in Bromley Adult Social Care, utilising £818,000 of the Better Care Fund.

 

Successfully tested by a number of recent national pilot schemes, the Discharge to Assess model supported people to leave hospital as soon as they were medically ready to be assessed for their long term care and support needs.  The assessment process took place outside of hospitals in a more familiar, community-based setting, and was focused on enabling people to return home wherever possible and reducing the amount of time people remained in a hospital bed unnecessarily which could lead to a decline in their levels of functioning, independence and wellbeing as well as having a significant cost implication.  It was proposed that a Discharge to Assess pilot scheme be implemented in Bromley to provide a temporary, community-based joint team of health and social care officers to support prompt hospital discharge and deliver a multidisciplinary enablement and assessment function alongside the existing hospital-based Care Management Team, with a view to establishing a permanent local Discharge to Assess model should the pilot scheme be successful.  The proposed pilot scheme would test three pathways comprising returning home, an interim placement at a ‘step-down’ facility and a long-term nursing home placement depending on people’s care and support needs.

 

In response to a question from the Leader, the Head of Discharge Commissioning confirmed that the current infrastructure would remain in place and the multi-disciplinary team would still exist enabling gatekeeping to be as rigid as possible.

 

The Portfolio Holder for Care Services stated that that this was an exciting pilot which would provide greater choice for residents.

 

In considering how the scheme would operate in terms of staffing, the Head of Discharge Commissioning reported that the plan was to establish the community-based joint team whilst working to transform existing hospital-based discharge and assessment processes.  Hospital staff would continue to be closely involved in discharging patients and service users would be supported to understand the potential costs of their longer term support needs at the point of discharge from hospital.  Existing staff had expressed a high level of interest in the Discharge to Assess pilot and no issues with recruitment were envisaged.

 

In response to a question from the Chairman of the Executive and Resources PDS Committee, the Head of Discharge Commissioning reported that the community-based joint team was a new team which would be pump-primed.  There had been a lot of interest from staff who were keen to be involved in the pilot and it was envisaged that the pilot would start relatively soon after the decision was taken as the model had already been developed.  Professionals were being sourced from across the health and social care partnership to ensure that no one service was disproportionately affected by staff secondment.  Funding from within existing resources would be used to backfill any staff that were seconded into the Discharge to Assess pilot.

 

Members noted that the report had been scrutinised by the Care Services PDS Committee on 9th October 2017.

 

RESOLVED: That

 

1.  The drawdown of £818,000 from the Better Care Fund (BCF) to support the implementation of a Discharge to Assess pilot in adult social care be agreed.

 

2.  That it be noted that an evaluation of the Discharge to Access pilot will be reported back to Members in May 2018.

 

Supporting documents: