Dumfries & Galloway

Dumfries & Galloway Action Plan

Dumfries & Galloway Delayed Discharge Action Plan 2006 - 2008

Lead Responsibility

Project title

Description

Anticipated Outcome

Cost

Margo Christie - Associate Director of Nursing

Short Term Augmented Response Service (STARS)

A region wide service, which allows individuals who, decline hospital admissions to be cared for at home, if appropriate. This includes individuals who chose to die at home. It also provides early supported discharge from hospital for those individuals who would have been delayed awaiting home care services.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Prevent unnecessary emergency admissions

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£230k

(A further amount of approx £100k was funded by Social Services)

Margo Christie - Associate Director of Nursing

Implementation of revised Admission/Transfer/

Discharge Document

Revised Admission/Transfer/Discharge Document introduced region wide.

Individuals will benefit from improved and enhanced discharge planning.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April

2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

Nursing Budget

Fidelma Eggo - Project Manager, Single Shared Assessment

Implementation of Single Shared Assessment

Individuals within a community hospital setting, whose assessments are carried out by one lead assessor with a holistic approach. Information and assessments are shared with all partners if appropriate and with the consent of the individual

Speed up assessment process and discharge planning

MGF

LHCC General Managers

Intermediate Care and Rehabilitation

Individuals who will be able to remain in their own home whilst receiving rehabilitation. Also, if appropriate patients will benefit from speedier assessment within hospital

.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April

2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£50k

Mike Shire, Operations Manager for Older People and Adults with Physical Disabilities

Funding of Placements

Appropriate individuals will be able to access care home places without having to wait for funding.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April

2008

Ensure quarterly sustainable reductions are made

£250k

Iain Boddy, General Manager, Mental Health Services

Community Support Services for Mental Health Phase 1 and 2

Individuals who require support during crisis and who could be offered alternatives rather than admitting them to hospital. Also to support individuals on earlier discharge from hospital.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Prevent unnecessary emergency admissions

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

Phase 1 - £90k

Phase 2 - £40k

Mrs J Muir, Joint Commissioning Manager

Dementia Development Team

Appropriate individuals whose assessments will be carried out more timeously.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£70k

Ms Marsali Caig, Joint Commissioning Manager

Targeted Rural Premium Payments for hard to reach areas to enable longer-term recruitment.

Individuals who require care packages in the more rural areas of the region who would otherwise be delayed in hospital.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Ensure quarterly sustainable reductions are made

Social Services budget

Ms Marsali Caig, Joint Commissioning Manager

Domiciliary Care Media Recruitment Campaign

Individuals who require care packages who would otherwise be delayed in hospital.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Ensure quarterly sustainable reductions are made

Social Services budget

Gordon Jamieson, Director of Nursing and Allied Health Professionals

Intensive Community Support

Individuals whose needs on discharge from hospital.

e.g.equipment

will be met

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£24k

Gordon Jamieson, Director of Nursing and Allied Health Professionals

Delayed Discharge Manager

Individuals who are delayed or potentially could be delayed. Also provides support and advice to other members of the multi-disciplinary team. Reports back to Dumfries and Galloway Delayed Discharge Partnership

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£43k

Jeff Ace, Director of Health Services

Senior House Officer

Individuals in the process of assessment and who may require to transfer to a community hospital for further rehabilitation/treatment.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£70k

Jeff Ace, Director of Health Services

Consultant Geriatrician

Individuals that required assessment within the acute and community hospitals. These individuals will receive an appropriate and faster response to a request for assessment.

Reduce delays over 6 weeks to zero by April 2008

Reduce the number of delays in short-stay beds to zero by April 2008

Speed up assessment process and discharge planning

Ensure quarterly sustainable reductions are made

£90k



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How data is collected and how often -

· Core information i.e. name, postcode, date of birth

· Date of admission

· Reason for admission

· Consultant/GP in charge of the patients care

· Date referred to social work

· Name of social worker/care co-ordinator allocated to the patient

· Date became a delayed discharge

· Intended destination on discharge

· Delayed discharge code - reason for delay

· Actual discharge date

· Actual destination discharge to

· Area in which patient is delayed in

The data is collected and monitored on a daily basis by the delayed discharge manager. This is done via telephone, e-mail and attendance at multi-disciplinary meetings.

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Page updated: Monday, October 02, 2006