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Delayed discharge from hospitalThe Community Care (Delayed Discharges) Act 2003 imposes penalties on local authorities who have failed to make arrangements for community care services for people who are ready to be discharged from hospital, and makes intermediate care and community equipment (minor aids and adaptations in the home) free of charge. The Act came into force in January 2004.
NHS bodies are required to explicitly notify the relevant local authority of individuals who they believe are likely to need community care services upon discharge from hospital, and to work with them to assess a patient's needs (pursuant to section 47 of the NHS and Community Care Act 1990). This is to ensure that the recipient social services authority can recognise this notice as the formal start of the process provided for under the Act.
The local authority will then have a number of days (at least two, according to regulations) to assess and put together a discharge plan in consultation with the relevant NHS bodies and determine which services it will provide to an individual upon discharge. Consultation is to ensure that a complete package of care can be put in place smoothly and without duplication or omission of any particular service.
There are two situations in which the local authority will be required to make a payment to the relevant NHS body:
The Act does not apply to those patients receiving mental health treatment. The health service will also need to check that a person actually needs an assessment for community care services; it may be that a person is self-funding and does not want assistance.
The Act also empowers local authorities to provide certain community care services free of charge, namely intermediate care and certain community equipment. The Community Care (Delayed Discharges etc) Act (Qualifying Services) (England) Regulations 2003 sets out the details with an implementation date of 9 June 2003. A 'community equipment service' involves the provision of minor aids and adaptations costing less than £1,000 to assist daily living. 'Intermediate care' is a short-term structured care programme to assist a person regain the ability to live in their own home.
The Delayed Discharges (England) Regulations 2003 and a number of linked directions and regulations make provision for the details of the delayed discharges scheme under the Act. Regulations will require the health service to assess for continuing care before passing a patient to a social services department. The daily 'reimbursement' payable when discharge is delayed will be between £100 and £120, depending on the authority.
The full version of this article, written by Stephen Cragg, appears in the Winter 2003 edition of the Disability Rights Bulletin.
The Department of Health has produced a 52 page toolkit, "Achieving timely ‘simple’ discharge from hospital – a toolkit for the multi-disciplinary team", intended for use by health professionals. Factsheet 8, contained within it, has information concerning delayed discharge from hospital. There is a link to it below. LAC(2003)14 is guidance.
