1. Impartial Assessor

2. impartial assessor

3. Care Home Impartial Assessor
Patient medically optimised for discharge
Care home receives assessment, agrees it
Impartial Assessor
completes assessment
Patient transferred back into a care home
An ‘Impartial Assessor’, employed by the Hertfordshire Care Home Providers Association, works at the acute hospital to speed the discharge process from hospital to care home, reducing delays
Operational hours:
Monday to Saturday 8am to 4pm
Benefits:
Facilitate the discharge process
Free up resources for Care Home staff
Increase bed-flow & status
Reduce miscommunications
Recruitment challenges

4. Roles and Responsibilities
Work within the hospital discharge team and social services based at Lister Hospital to act on behalf of social care providers to support and facilitate timely and safe discharges from hospital to care settings
Work with agreed assessment formats (standardised across county).  
Undertake assessments and re-assessments on behalf of care providers in Hertfordshire
Work in partnership with care settings and the hospital to find solutions to issues arise that delay discharge
Work with relevant ICT systems, including social care and NHS.  
Provide full evaluation for reporting purposes on assessments, information dissemination, discharges, bed days saved and write monitoring reports as required.

5. What does the assessment currently cover?
Reviewing infection and therapy reports
Provide a copy of the current drug chart
Reviewing skin integrity
Update on requirements of patient
District Nurse referrals
Reviewing blood tests
Ensuring the information reflects the patient needs

6. Impact of the service – August 2016 onwards
358
459
Assessments led to a discharge into a care home
Assessments conducted by the assessor
624
Caveat – challenge to validate the figures as not always recorded.
Referrals for the service are coming from across the hospital and care homes
And taking £525/ bed day.. This led to potential savings of £327,600
.. which led to 421 bed days saved

7. Challenges Challenges How are we tackling this?
Access to ICT systems, information on variety of systems. Information Governance
NHS honorary contract.
Recruitment to post (not on NHS terms and conditions)
Shared on partner job sites
Currently looking for secondment via HCT
Care Home buy-in
HCPA employ individual = ‘independent’ nurse
Engagement with care homes
Continuous learning and best practice
Lots of different referral points
Working closely with discharge team & social services to map them. Based in both offices to help reduce gap
Ward buy-in
Additional communication and engagement with wards
Validating and receiving data related to impact of post
Developed a manual system of reporting. Now working with Trust and Integrated Discharge Team to improve the reporting and validity of information

8. Next steps
Service is being expanded to all the other two acute hospitals in the Hertfordshire and west Essex STP area next week, as a five-day service
Watford Hospital - 7 November
Princess Alexandra Hospital (joint with Essex CC) – 8 November
Service expanding at Lister Hospital from December. As part of a pilot scheme, a care home ‘Choice Facilitator’ will be employed from the December to advise patients and family members on next steps – this role is particularly aimed at advising those who are funding their own care.
Draft and agree a Memorandum of Understanding for all care homes to sign up to the service