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Intermediate care including reablement [NG74]

Measuring the use of this guidance

Recommendation: 1.1.3

Intermediate care practitioners should: - work in partnership with the person to find out what they want to achieve and understand what motivates them - focus on the person's own strengths and help them realise their potential to regain independence - build the person's knowledge, skills, resilience and confidence - learn to observe and guide and not automatically intervene, even when the person is struggling to perform an activity, such as dressing themselves or preparing a snack - support positive risk taking.

What was measured: Proportion of service users who replied 'yes - definitely' to the question 'I was aware of what we were trying to achieve'.
Data collection end: August 2017
96%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.2.1

Consider making home-based intermediate care, reablement, bed-based intermediate care and crisis response all available locally. Deliver these services in an integrated way so that people can move easily between them, depending on their changing support needs.

What was measured: Proportion of commissioners who stated that they commission an integrated service that covers home-based intermediate care and reablement services.
Data collection end: August 2017
51%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of commissioners who stated that they commission an integrated service that covers home-based and bed-based intermediate care services.
Data collection end: August 2017
51%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.2.2

Ensure that intermediate care is provided in an integrated way by working towards the following: - a single point of access for those referring to the service - a management structure across all services that includes a single accountable person, such as a team leader - a single assessment process - a shared understanding of what intermediate care aims to do - an agreed approach to outcome measurement for reporting and benchmarking.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have a single point of access.
Data collection end: August 2017
53%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have a single assessment process for these services.
Data collection end: August 2017
36%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have a single management structure for these services.
Data collection end: August 2017
29%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have a single performance management framework across these services.
Data collection end: August 2017
39%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have a single point of access.
Data collection end: August 2017
45%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have a single assessment process for these services.
Data collection end: August 2017
41%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have a single management structure for these services.
Data collection end: August 2017
32%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have a single performance management framework across these services.
Data collection end: August 2017
32%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.2.3

Ensure that the intermediate care team has a clear route of referral to and engagement with commonly used services, for example: - general practice - podiatry - pharmacy - mental health and dementia services - specialist and longer-term rehabilitation services - housing services - voluntary, community and faith services - specialist advice, for example around cultural or language issues.

What was measured: Proportion of crisis response intermediate care services which are required to ask a GP to make a mental health referral.
Data collection end: August 2017
30%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of home-based intermediate care services which are required to ask a GP to make a mental health referral.
Data collection end: August 2017
33%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of bed-based intermediate care services which are required to ask a GP to make a mental health referral.
Data collection end: August 2017
18%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of reablement services which are required to ask a GP to make a mental health referral.
Data collection end: August 2017
34%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of crisis response intermediate care services which have mental health as part of the establishment.
Data collection end: August 2017
22%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of home-based intermediate care services which have mental health as part of the establishment.
Data collection end: August 2017
20%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of bed-based intermediate care services which have mental health as part of the establishment.
Data collection end: August 2017
8%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of reablement services which have mental health as part of the establishment.
Data collection end: August 2017
7%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of crisis response intermediate care services which have mental health liaison team in-reach into the service.
Data collection end: August 2017
4%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of home-based intermediate care services which have mental health liaison team in-reach into the service.
Data collection end: August 2017
3%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of bed-based intermediate care services which have mental health liaison team in-reach into the service.
Data collection end: August 2017
31%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of reablement services which have mental health liaison team in-reach into the service.
Data collection end: August 2017
15%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of crisis response intermediate care services which have direct referral to mental health services.
Data collection end: August 2017
37%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of home-based intermediate care services which have direct referral to mental health services.
Data collection end: August 2017
41%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of bed-based intermediate care services which have direct referral to mental health services.
Data collection end: August 2017
39%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of reablement services which have direct referral to mental health services.
Data collection end: August 2017
27%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.2.7

Consider deploying staff flexibly across intermediate care, where possible following the person from hospital to a community bed‑based service or directly to their home.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have staff working across services.
Data collection end: August 2017
56%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have staff working across services.
Data collection end: August 2017
46%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.5.3

For bed-based intermediate care, start the service within 2 days of receiving an appropriate referral. Be aware that delays in starting intermediate care increase the risk of further deterioration and reduced independence.

What was measured: Proportion of bed-based intermediate care services reporting that no-one waited more than 2 days from referral to commencement of service.
Data collection end: August 2017
26%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.


Recommendation: 1.6.3

Ensure that staff across organisations work together to coordinate review and reassessment, building on current assessment and information. Develop integrated ways of working, for example, joint meetings and training and multidisciplinary team working.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have weekly multidisciplinary team meetings attended by health and social care staff.
Data collection end: August 2017
71%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based intermediate care and reablement services which have a joint training and induction programme for health and social care staff in these services.
Data collection end: August 2017
31%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have weekly multidisciplinary team meetings attended by health and social care staff.
Data collection end: August 2017
59%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.

What was measured: Proportion of integrated home-based and bed-based intermediate care services which have a joint training and induction programme for health and social care staff in these services.
Data collection end: August 2017
30%
Area covered: England
Source: NHS Benchmarking Network. National Audit of Intermediate Care.



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