Coordinated discharge planning based on joint assessment processes and protocols and on shared and agreed responsibilities promotes effective discharge and positive outcomes for patients.
Some things that people have told us about what works and how to overcome the challenges
- focus on decision-making in the right place making it a principle that assessment for long-term care should not take place in hospital
- overcoming possible bottlenecks by not sending simple discharges to the integrated team
- involving voluntary and community sector organisations with self-funders who may not want to talk to adult social care.
- NHS England, quick guide to identifying local care home placements
- NHS England, quick guide to sharing patient information
- NHS England, quick guide to health and housing
- NHS England, MDT Development – working toward an effective multidisciplinary/multiagency team
Examples of local initiatives
High impact change model examples of emerging and developing practice
The model identifies eight system changes that will have the greatest impact on reducing delayed discharge.
Better Care Fund
The Better Care Fund was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and care.