Decision details

On 4 June 2013 the Health & Wellbeing Board received a report which outlined the design principles for the new Joint Assessment and Discharge Service. This report will ask the Board to agree the service specification and give approval to proceed to implementation with the new service scheduled to be operational from April 2014.

Bruce Morris introduced the report to the Board. As well as outlining the process for implementing the Joint Assessment and Discharge (JAD) proposals through the three borough’s Health and Wellbeing Boards and the Integrated Care Coalition, Bruce Morris explained how the new service would simplify hospital discharges, make better use of resources, and improve integration.

The Board noted that identifying a host organisation for the service has been a difficult process as there are complexities due to the sums of money and numbers of staff involved. To ensure accountability and clarity in relation to service delivery it is recommended that the Integrated Care Coaltion partners enter into section 75 agreements with performance of the service monitored by an Executive Steering Group made up of Coalition partners. 

Dr Gill (Medical Director, BHRUT) commended the development of the JAD and believed that outcomes for patients could be further improved by adding in quality standards. For example, Dr Gill suggested that all occupational therapy should be done in the home and that nursing care placements could only be given once a full assessment has been conducted.

Dr John (Clinical Director, B&D CCG) offered his support to the JAD proposal and encouraged innovations that improve integration. He felt that the JAD would result in speedy discharge from hospital which in the past has been problematic.

Anne Bristow (Corporate Director, Adult and Community Services) commented that there needs to be a consistent approach among professionals about the advice given to patients, especially from doctors. A Patient in hospital will tend to regard the advice of their doctor as more compelling than that of other professionals. It is therefore important that doctors offer advice that does not conflict with the advice of social work teams in relation to care issues 

Dr Gill offered to collaborate on any training to help change the mind set of Hospital Trust employees working in the new set-up. He felt it was important to confront the culture of recommending patients to nursing or residential placements when the home setting with the right care package is the best environment following discharge. 

The Health and Wellbeing Board agreed to delegate authority to the Corporate Director of Adult and Community Services to enter discussions with Coalition partners on the proposals and agree implementation.