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Transition between inpatient hospital settings and community or care home settings for adults with social care needs [NG27]

Measuring the use of this guidance

Recommendation: 1.3.10

Start a comprehensive assessment of older people with complex needs at the point of admission and preferably in a specialist unit for older people.

What was measured: Percentage of acute trusts or local health boards who have a frailty unit (an acute assessment unit focused on the care of frail and older people).
Data collection end: October 2016
52%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.

What was measured: Percentage of acute trusts or local health boards who report having a multidisciplinary team response that initiates a comprehensive geriatric assessment within the first hour of admission.
Data collection end: October 2016
26%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.


Recommendation: 1.5.1

Make a single health or social care practitioner responsible for coordinating the person's discharge from hospital. Create either designated discharge coordinator posts or make members of the hospital‑ or community-based multidisciplinary team responsible. Select them according to the person's care and support needs. A named replacement should always cover their absence.

What was measured: Percentage of acute trusts or local health boards with dedicated ward discharge co-ordinators.
Data collection end: October 2015
79%
Data collection end: October 2016
70%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.


Recommendation: 1.5.3

Health and social care organisations should agree clear discharge planning protocols.

What was measured: Proportion of acute trusts or local health boards who have a documented supported discharge protocol applied across all wards.
Data collection end: October 2015
86%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.

What was measured: Proportion of acute trusts or local health boards who have a documented supported discharge protocol applied across all wards.
Data collection end: October 2016
77%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.


Recommendation: 1.6.1

Ensure that a range of local community health, social care and voluntary sector services is available to support people when they are discharged from hospital. This might include: reablement (to help people re‑learn some of the skills for daily living that they may have lost) other intermediate care services practical support for carers suitable temporary accommodation and support for homeless people.

What was measured: Proportion of older people (65 and over) who were offered reablement services following discharge from hospital.
Data collection end: March 2014
3.3%
Data collection end: March 2015
3.1%
Data collection end: March 2016
2.9%
Data collection end: March 2017
2.7%
Data collection end: March 2018
2.9%
Number that met the criteria: 44757 / 1524615
Area covered: England
Source: Adult Social Care Outcomes Framework, England



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