Review of bed based intermediate care

About this report

We surveyed 20 GPs, five Occupational Therapists, and two relatives of people in bed based immediate care. 

Recommendations

Planning for the proposed Care Complex

• Trafford CCG should benchmark its intermediate care return against the overall NAIC results published in November 2017 and use this information as the basis for planning the proposed care complex. This should include the overall financial benefit to the soon to be established integrated health and social care organisation.
• Health and Social Care should determine the preferred model encompassing capacity required for the period up to 2030, having regard to the standards required in the recently published NICE guideline.
• The main consideration should be whether intermediate care services can provide an integrated nurse-led model (as opposed to the current therapy-led model) supported by the full range of practitioners advocated in the NAIC audit within the available resource set against savings in acute sector activity as a consequence of shorter lengths of stay or hospital avoidance.
• The health and wellbeing benefits for patients should be uppermost and routinely evaluated.

Short term measures

•  In the short term, the admission criteria to Ascot House should be reviewed to include people with cognitive impairment, physical and learning disabilities.
• There should be efforts to encourage and enable people from ethnic minorities to use Ascot House.
• There should be organised activities for residents of Ascot House.
• A list of conditions that would be suitable for step-up to avoid hospital admission should be agreed between GPs and the acute sector and performance managed to ensure change in behaviour to effect hospital avoidance.
• The use of the Trafford Coordination Centre as the single point of access and information and advice to referrers in terms of bed availability, access criteria etc. should be explored.
• The ‘trusted assessor’ pilot to ensure that patients are only assessed for intermediate care once, should be implemented as quickly as possible.
• The role and function of Ascot House should be widely communicated and, where possible, acute and community staff exchange visits should be encouraged.
• Efforts should be made to improve connectivity between IT systems.