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Preparation issues for acute trusts

  • Last modified date:
    8 February 2007

This list of key issues is designed to assist the preparation by acute Trusts for reimbursement implementation from 1st October 2003, when NHS acute Trusts acquire a number of new statutory responsibilities under the Community Care (Delayed Discharges etc.) Act 2003.

  1. Are senior managers and relevant others in the acute Trust familiar with the intentions of the Act and its provisions, including the new statutory duties placed on their organisation?The Act and Regulations are available from the Legislation and Publications page, and FAQs are available on the Questions and Answers page.
  2. Has the Trust been fully involved with its local PCTs and SSDs in considering the local implementation of the Act and its implications for the local health and social care economy?Are systems in place for the Trust to be able to identify those patients likely to need community care services on discharge?
  3. Are arrangements in place to notify SS about these patients (Assessment Notification -Section 2) and their proposed discharge date (Discharge Notification-Section 5)? Is it understood that reimbursement does not apply unless the two notifications have been made?A detailed Notification Protocol Checklist is available on the Guidance for Implementation page.
  4. Are arrangements in place to ensure that there is initial consideration of eligibility for NHS continuing care before patients are referred to SS?
  5. Are Trust staff able accurately to identify the local authority of residence of patients, as required for the purposes of notification? Have cross boundary issues been addressed and protocols put in place?A Cross Boundary protocol checklist is available from the Guidance for Implementation page.
  6. Has the Trust considered the definition of acute care as it relates to reimbursement? Is there agreement with the PCT and SS about which beds would typically contain patients receiving acute care, according to this definition?A Reimbursement and Acute Care protocol checklist is available from the Legislation and Publications page.
  7. Have discussions been held with the PCT and SS about the use to which any reimbursement income would be put, including opportunities to invest in services to prevent delays?A paper on Whole Systems Investment and Finance is available on the Guidance for Implementation page.
  8. Are arrangements in place to ensure appropriate involvement of patients and their carers in the discharge planning process and do these incorporate a clear and consistent approach to patient choice?A Patient and Carer Protocol checklist is available on the Guidance for Implementation page.
  9. Are there procedures to resolve differences /disagreements, wherever possible without recourse to the formal inter-authority disputes procedure? Where it is necessary to register a dispute under the latter, is it clear how it would be invoked, and by whom?A Disputes Protocol is available on the Guidance for Implementation page.
  10. Have the necessary connections been made between the work on reimbursement and whole systems capacity planning, review of discharge planning arrangements and the introduction of the single assessment process?

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