NICE publishes draft guideline on joined-up services
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The National Institute for Health and Care Excellence (NICE) has published a draft health and social care guideline to help manage the complicated needs of adults being admitted to and discharged from hospital who are receiving or need support from social care. The focus of the guideline is on adults with health and social care needs – and who have or will need support from a range of practitioners such as family doctors, social workers, physiotherapists, or community nurses.
The draft guideline recommends ways to integrate effectively social care with medical support during transition to and from hospital. It addresses how services should work together and with the person, their family and carers, to make sure they are admitted for medical treatment in a timely way and spend no longer in hospital than is necessary.
From April 2014 to March 2015, hospitals lost thousands of bed-days as people waited for care to be put in place:
- 174,138 days waiting for a place in a residential home;
- 215,662 days waiting for a nursing home place to become available;
- 206,053 days for help from social care workers or district nurses to enable people to return to their own home;
- 41,389 days for home adaptations ranging from grab rails to ramps and stairlifts.
NHS England says hospitals lost 2,442,014 bed days between June 2010 and March 2015 as people waited for social care. According to Age UK, an NHS bed costs on average £1925 a week compared to about £558 for a week in residential care or £356.58 for home care based on three hours of care per day over the course of one week.
The guideline says that from admission, or earlier if possible, hospital-based and community-based multidisciplinary teams should work together to identify and address factors that could prevent a safe, timely transfer of care from hospital. The factors could include homelessness, safeguarding issues, or finding a place in a suitable care home if their own home is no longer appropriate. The guideline says that local health commissioners should keep all care providers, including GPs and out-of-hours services, up-to-date on the availability of local health and social care services.
Andrea Sutcliffe, chief inspector of adult social care at the Care Quality Commission, welcomed the draft guidance from NICE which, she said, reinforced the importance of services focusing on the needs of the person, not the organisation.
“Our inspections do identify some really good examples of joined up care, but we only have to look at our Cracks in the Pathway review – exploring the experiences of people living with dementia as they moved from care home to hospital and back again – to know that transitions between services need to be improved so that safe, compassionate, effective and high-quality care becomes the norm for everyone,” said Ms Sutcliffe.
“Information that isn’t shared properly, poor planning, lack of communication and inconsistent monitoring around a person’s quality of care as they move around the health and social care system are some of the everyday problems we see in our inspection work.”
The draft NICE guideline has now been published for consultation. Local authorities, clinical commissioning groups, home care organisations and other social care groups are encouraged to comment on the draft recommendations before the consultation ends on 6 August 2015 to contribute to the further development of the recommendations.
The final guideline is expected to be published later this year.
- The draft guideline is available at http://www.nice.org.uk/guidance/indevelopment/gid-scwave0712