The BGS discussion board on the BGS website is off to a slow start. Most of the activity is around the Single Assessment Process where people have responded to a poll asking, “do you think that the SAP as implemented in your area triggers comprehensive assessments? If yes, please describe how this is working, illustrating good practice or any qualifications to the answer ‘Yes’”.

Thank you to those who have responded to the poll - their responses are published below. I would urge others to do the same.

Ian Donald
Co-chair Primary and Continuing Care SIG

Reply
My experience has been that the SAP is seen as documentation that does not really have a major role in the delivery of care, and is not the trigger to the specialist or comprehensive assesments that I see taking place in various settings. The trigger remains usual clinical practice, and the presence or absence of functional referral pathways.
JG

Reply
I'm not sure; there is certainly assessment, but I am not so clear about the intervention aspect, without which the assessment counts for little. The SAP used locally is comprehensive, but I am unable to describe clear events where it appears to have triggered an intervention, certainly not since I am been working as a community geriatrician (only 9 months!).

Many of the services for older people are demedicalised, although this is changing gradually, for example we are now supporting residential intermediate care. Because of this it is difficult to gauge how effective SAP is locally.
SC

Reply
In Wales we are only just in the beginning phase of implementation of what we call unified assessment. Some areas are further ahead but most medical colleagues are concerned about the amount of paperwork, the lack of IT help which means the assessment/ referral forms etc. are on paper only and the lack of any involvement of primary care in the exercise. There seems to be a belief that assessment is a one off exercise rather than an ongoing process and the lack of ability to alter data in an online record makes it hard to ensure that the patients altered status at any time is reflected by the paperwork.
I'm not aware of any examples where U/A itself has triggered CGA though social workers have always been able to seek medical /team involvement when they feel an undiagnosed problem might account for social decline.
AD

Reply
Social Workers seem to be attempting to use Easycare. Other than that I don't detect much effective use of the SAP - indeed I think Wirral, is being criticised for lack of implementation. It seems to me it won't work unless we all share the same Information Technology. Actually in Wirral the hospital, PCTs and the local authority share the same IT service but that doesn't seem to have helped SAP yet.
CT

Reply
We've found staff find the Overview assessment much more comprehensive than their normal assessments. The accredited Comprehensive Assessment tool MDS does not currently link electronically to EasyCare, so there appears to be a choice as to whether one starts a comprehensive or an overview. So far we've been pushing the overview as the main SAP tool, but the different accredited tools need to link in better before the Comprehensive level of assessment will take off electronically I think.
BN