Agenda and minutes

None Received

The Chair will consider the admission of any late items of urgent business. Where the item is already on the agenda it will be dealt with under that item but new items of urgent business will be dealt with at item 5.

None

A member with a personal interest in a matter who attends a meeting of the authority at which the matter is considered must disclose to that meeting the existence and nature of that interest at the commencement of that consideration, or when the interest becomes apparent.

A member with a personal interest in a matter also has a prejudicial interest in that matter if the interest is one which a member of the public with knowledge of the relevant facts would reasonably regard as so significant that it is likely to prejudice the member's judgement of the public interest.

None received

The review panel will receive a presentation from the Expert Adviser setting out Government thinking and giving examples of good working practice within Intermediate Care.

Members received a presentation from the Expert Adviser to the Panel setting out the national context of Intermediate Care and outlining essential components and proposals for the future.

It was noted that since the 1930’s the number of over 65’s had more than doubled and now more than one fifth of the population was over 60. Between 1995 and 2025 the number of over 80’s would increase by almost half and the number of over 90’s would double. Older people occupied 65% of acute sector beds. Transfers from acute wards accounted for 63% of nursing home admissions and 43% of residential home admissions. Less than 3000 beds per day were occupied by people awaiting discharge and most of these beds were occupied by people with Mental Health needs. It was noted Intermediate Care needed to address the needs  of people with mental health issues.

Intermediate Care was seen as:-

·        An emerging concept in health care

·        May offer attractive alternatives to hospital care

·        Care that is "in between"

·        Arises out of a policy imperative

·        Intermediate Care is delivered by those health (and social care) services that do not require the resources of a general hospital but are beyond the scope of the traditional primary care team (BGS)

Intermediate Care should focus on three key points in the pathway of care:-

responding to or averting a crisis, active rehabilitation following acute hospital stay and where long term care is being considered

The NSF for Older People (Standard 3) defined Intermediate care as:-

To provide integrated services to promote faster recovery from illness, prevent unnecessary acute hospital admissions, support timely discharge & maximise independent living.

   (This includes adults with complex needs and older people with mental health needs)

There was a discussion as to who made the decision on care particularly where there was a variety of needs and if the criteria meant that they could not be accommodated by IC then the decision would be taken to provide acute care. Acute care should deliver treatment for people with complex needs and then they should move to IC following an in depth assessment linked to objectives. It was noted that in Haringey  a significant number of people went to Stamford or St Ann’s whilst a longer term decision was made, purely because there was not sufficient  alternative provision.

The LAC 2001 specified that the average duration of IC was 2-4 weeks but it could be extended for up to 12 weeks for people with complex needs.

A whole systems approach was required which involved:

w        Self Care – Advice and Carer Support

w        Multi-agency prevention

w        Voluntary Sector

l      Primary Care

l      Housing

l      Health and Social Services

w        Community Nursing / Therapy / Social Care Support

w        Intermediate / Interim / Transitional Care

w        Secondary Care

l      Fast Track Medical Assessment and Treatment

l      Specialist Nursing and Therapy

It was acknowledged that acute nurses needed training on IC. The Panel noted that the ICT rehab team attended multi -disciplinary  ...  view the full minutes text for item 4.

To deal with any new items of urgent business admitted at item 2 above.