As a significant time has elapsed since the introduction of the delayed discharge reimbursement policy between NHS and Social Service departments in England, the BGS England Council surveyed the initial impact of the policy.

The questionnaire was sent to each BGS regional secretary for onward transmission to the lead clinician for older people’s services in each acute trust.

Twenty seven responses were received from 26 acute trusts. One trust sent separate responses for both social services departments that it relates to. Eight trusts sent their local delayed discharge data. In only one respondent, was there a convincing downward movement in the number of delayed discharges. In the others, the numbers varied from week to week. The interim results are summarised here.

James Barrett
Vice Chairman
BGS England Council

Q: Does your trust/directorate produce/receive regular information on delayed discharges? If so, please append the relevant data that will illustrate the recent trend.
Yes: 26; No: 2; Don’t know: 0

Q: Is the local council’s budget for reimbursement ring fenced?
Yes: 18; No: 3; Don’t know: 5

Q: Are the national criteria for reimbursement being used?
Yes: 21; No: 2; Don’t know: 2

Q: Have any beds in your trust been designated as ‘non-reimbursable’ (e.g. rehabilitation beds)? Yes: 14; No: 12; Don’t know: 0

Q: Has reimbursement money been used to stimulate the development of services for older people? Yes: 22; No: 0; Don’t know: 2

The respondents highlighted the following examples of developments that have been or will be funded through this initiative in different local health economies:

• Development of intermediate care schemes, usually jointly planned, but not always
• tDevelopment of chronic disease case management schemest Discharge co-ordinators
• Additional social workers e.g. in A&Et Falls service developmentst Transitional care arrangements in care homes (usually 3 or 6 beds per scheme). Two trusts are jointly planning much greater numbers of transitional beds in care home setting.
• Some existing intermediate care facilities are becoming the delayed discharge waiting area and are no longer able to offer a rehabilitation environment where it had previously existed
• Change Agent Team cited as contributing to facilitating joint work between all the health and social care agencies