Supporting hospital discharge: Discharge to Assess part 2

So a while ago, I said I would do another post on the Discharge to Assess operating model, focussing on the detail, after my last post looked at the broad principles. It has taken me some time to do for a few reasons. Firstly, because I am expecting revised guidance as the emergency covid fundingContinue reading “Supporting hospital discharge: Discharge to Assess part 2”

Supporting hospital discharge: Discharge to Assess part 1

This should really have been the first in my hospital discharge series, this being the most far-reaching of the policies I have explored. But its taken me a while to order my thoughts on this, and I’ve ended up breaking this into two posts. In this one, I’m going to talk ‘broad brush’ principles andContinue reading “Supporting hospital discharge: Discharge to Assess part 1”

A return to the problem of ‘unco-operative patients’

I have written before about the difficulties I have encountered in practice in relation to individuals who do not co-operate with those trying to provide care and support. It’s causing particular issues with one of my cases this week, so I thought I would share. UP has a diagnosis of Emotionally Unstable Personality Disorder andContinue reading “A return to the problem of ‘unco-operative patients’”

Supporting hospital discharge: halfway hotels

This is the second in my series of posts about supporting hospital discharge during the pandemic. It will explore the as yet unnamed proposals for discharge hotels in all their complicated, vague glory. The first of those posts discussed designated settings for covid positive patients, and the complications involved in the creation of such settingsContinue reading “Supporting hospital discharge: halfway hotels”

Supporting hospital discharge: Designated settings

There are lots of bright ideas floating around at the moment about what social care can do to help ease pressures in NHS services. I’m going to talk through a few of them, because they are being made to seem much more straightforward than they actually are. Let’s begin with designated settings. When I talkedContinue reading “Supporting hospital discharge: Designated settings”

Winter is coming – a brief word on the adult social care winter plan

There is so much guidance coming out at the moment that it is almost impossible to keep on top of it. I’m not even going to try to comment on every bit of it as it comes up. And I’ve already read Alex Ruck-Keane’s walk-through of the latest MCA guidance, I’m sure most of youContinue reading “Winter is coming – a brief word on the adult social care winter plan”

Social care and health care joint working arrangements – what can go wrong

This post discusses a case example from my practice, suitably anonymised, where the local authority and NHS Clinical Commissioning Group should be working together to support a hospital discharge for an incapacitated adult, but that, to date, hasn’t quite worked out. Safety warning: I do work for the local authority here, so I’ll try toContinue reading “Social care and health care joint working arrangements – what can go wrong”

Best interests and coronavirus testing

I am going to start this post by saying that I have read the very useful note by 39 Essex Chambers on this point. I am certainly not naive enough to think that I know better than they do how the principles apply. But I did think it might help to look at some ofContinue reading “Best interests and coronavirus testing”

Tensions around hospital discharge

Hospital discharge arrangements are often a cause for tension or dispute. This won’t be a surprise to anyone who has had to get involved in these cases. And it’s understandable that this will occur, there are a lot of competing interests involved. For example, pressure on hospital beds are a big driver on NHS TrustContinue reading “Tensions around hospital discharge”