Our healthcare solicitors have already blogged on the guidance from the Department for Health and Social Care about Hospital Discharge, NHS Continuing Healthcare and the implications on funding care.
The intention is that people will be discharged from hospital as soon as possible after being declared fit for discharge, with the intention of freeing up much needed hospital beds. Providers need to ensure they have read and understand Section 8 of that guidance. In order to achieve this new scheme, the rules have been updated in respect of the “Trusted Assessor” scheme which was already starting to be rolled out prior to the COVID-19 outbreak.
What is the Trusted Assessor initiative and who are Trusted Assessors?
The Trusted Assessor initiative driven by the NHS seeks to reduce the number of delayed discharges from NHS Trusts to adult social care services. Trusted Assessors are individuals that must have the appropriate qualifications, skills, knowledge and experience to carry out health and social care assessments.
Trusted Assessors are required to have a working knowledge and good understanding of a providers’ service and the services they can provide, and the care needs they can meet. Likewise, providers must be confident that the Trusted Assessors have that knowledge and that the discharges they undertake will be appropriate for the patient being discharged.
Trusted Assessor Agreements
Trusted Assessors can be employed by a range of organisations, this could be adult social care providers, hospital trusts or “collaborative arrangements” which would be appropriate and suitable for the skills of that particular Trusted Assessor. The specific arrangements are set out in a “Trusted Assessor Agreement”.
Trusted Assessors Agreements, like Trusted Assessors themselves, can be in a range of formats. By way of example, CQC’s guidance references a “co-designed memorandum of understanding between NHS Trusts and adult social care providers” as being a suitable type of Trusted Assessor Agreement.
The Trusted Assessor agreements must contain a variety of different provisions and these can be found within the CQC’s guidance on Trusted Assessors.
Who maintains responsibility for meeting legal requirements in relation to assessments?
CQC has explicitly stated that the responsibility of meeting legal requirements in relation to care planning and assessments will always remain with the provider. There must therefore be sufficient systems and processes in place for providers to escalate concerns about the appropriateness of a discharge to their service by a Trusted Assessor. There is a responsibility on providers to undertake their own assessments once the patient has been discharged to them, to ensure the decision taken by the Trusted Assessor is suitable and safe.
New CQC Guidance
CQC has also produced additional guidance in relation to Trusted Assessors which will apply until further notice. In summary, the key changes from existing arrangements are:
- All hospitals will train additional staff to operate as Trusted Assessors. The additional staff will supplement the current Trusted Assessors who are in place in the current schemes.
- Most hospital trusts already use Trusted Assessors at the current time. These schemes should be kept up to date using the NHS Discharge to assess arrangements.
- CQC will inspect if there are serious concerns about the safety of people using this scheme.
- Providers and managers need to have confidence that legal requirements will be met. There must be a particular focus on infection control and safety.