Single Assessment Process

Regional Overview from

North and East Yorkshire and Northern Lincolnshire SAP Learning Consortium.

Some Common Givens

• All Partners– are committed to focusing on the needs of users/carers at

the centre of their processes.

– have stages in their assessment processes identical to or similar to those outlined in SAP

– have numerous examples of multidisciplinary teams

– cover the domains outlined in guidance

– have agreed common data sets

– have agreed common assessment tools for their area

– The majority have plans and timetables for detailed pilot work on electronic exchange of data and assessments

• However there are also a range of electronic pilots at different stages of development

Harrogate Pilot

• Fast Response Team -Intermediate Care

• Partner organisations:– North Yorkshire Social Services – Harrogate Borough Council– Harrogate Healthcare Trust

• An electronic pilot – EasyCare/MDS using Liquid Logic

The Craven pilot

• will include all elderly clients in the South Craven area.

• Partner Organisations – Social Services Community care Team – GP Practices, – Craven, Harrogate and Rural District PCT – Airedale NHS Trust.– Craven District Council

• An electronic pilot – EasyCare/MDS using Liquid Logic

North East Lincolnshire

• Patients of 1 Primary Health Care Team who are moving from community to intermediate care or from acute to IC.

• Partner organisations:– N. E. Lincolnshire Council– N.E. Lincolnshire PCT– Northern Lincolnshire & Goole Acute NHS

Trust• An electronic pilot – EasyCare/MDS using Liquid

Logic

North Lincolnshire - -Scunthorpe

• Geographical location: specifically looking at the interface between intermediate care and two wards at Scunthorpe General Hospital.

• Partner organisations:– North Lincolnshire Council, – North Lincolnshire PCT, – North Lincolnshire General Hospital

• An electronic pilot – EasyCare/MDS using Liquid Logic

Scarborough Area

• Those patients referred to the Community Assessment and Rehabilitation Team from Filey Surgery

• Partner organisations:– GP Surgery and health team– Scarborough Acute Trust– Social Services team

• An electronic pilot – EasyCare/MDS using Liquid Logic

Selby and York PCT area

• Using SAP within an Intermediate Care setting – both residential and home based. Primarily for people aged 65 plus but not exclusively as some people under 65 can access the scheme if they live in their own homes,

• Partner organisations:

– Selby and York PCT

– Acute Trust

– North Yorkshire County Council

– City of York Council

• Will be a paper based process using locally developed tools

Driffield Alfred Bean Hospital & Hull, Acute Trust Pilots

• Driffield: District Nursing, community mental health team, care management team (Social Services), GP ward + Day hospital ABH, East Riding intermediate care

• Hull: NHS Continuing care team, two medical elderly wards (ward 5, castle hill hospital, ward 23 HRI), Integrated transfer of care team, social services – training & development team, and emergency duty team.

• Partner organisations:

– Eastern Hull Primary Care Trust

– East Riding of Yorkshire Council

– GP Practices

– Hull City Council

– Hull and East Riding

Community Health NHS Trust

– Hull and East Yorkshire Hospitals NHS Trust– Private Residential Homes– Voluntary organisations e.g. Red Cross– West Hull Primary Care Trust– Yorkshire Wolds and Coast Primary Care Trust

An electronic pilot – EasyCare/MDS using Liquid Logic

The Hambleton & Richmondshire pilot

• is around the Independent Living Scheme at the Friary Hospital, Richmond. 12 community hospital beds and 6 intermediate care beds.

• Partners:– NYCC Social Services, – Hambleton & Richmond PCT, – South Tees NHS Trust and – Key GP Practices

• An electronic pilot – EasyCare/MDS using Liquid Logic

Some Common Challenges

• Receiving a national direction and a set of principles in itself was not enough

• Long discussions and delays nationally on accredited assessment tools initially focused the attention on tools and not processes.

• The initial national emphasis seemed to be on electronic process ..e.g. Cambridge was the national example!

• The ultimate measure of success was lauded as a electronic assessment summary record.

• No understanding or investment on how this was to be delivered across wide geographical areas and across boundaries without IT systems.

• The stagnation of the National Health IT strategy resulted in a vacuum of planning and the absence of commitment to the SAP agenda.

• So at many locality levels there was no designated ‘lead’ from the start, problems with fitting SAP priorities within day jobs – no resources to fund roles.

• ‘Patient involvement’ is a difficult issue – older people are not keen on attending policy meetings

• Confusion by the sheer amount of SAP information out there!

Some Common Challenges

• managing cross-boundary issues (e.g. a trust or team working with more than one area or organisation.

• unfamiliarity with new assessment tool, & any supportive IT • supporting staff during a new learning process (when inevitably they will

be under increased pressure), • Freeing staff up for training in new common tools• Getting understanding of acute Trust re: EPR & IT• Integration of IT systems big challenge• Getting agreed collective direction caused long delays.• The cost & complexity of connecting a number of dispersed workplaces

(always an issue in a rural areas), • Some agencies see SAP as a very small part of their work and because

of other major I & MT work and financial difficulties SAP until lately fell to the bottom.

• Paper based approaches across complex and widely dispersed localities is extremely difficult to manage

Moving Forward and making it happen –finding solutions.

• Working in focussed specific areas:

– Teams where patient/user flows are shared:

Hospital discharge Mental health teams

Learning disability teams, Rehabilitation teams

The challenge involved and skills required to this not to be underestimated.

• Working in tight geographic locations

• Linking professions who are in close proximity

Linked to a GP Practice Linked to a hospital ward or rehab unit or particular rural area.

Moving Forward and making it happen –finding solutions.

• Agreed common assessment tools across agencies:– * LAs and * PCTs in the North East and Yorkshire and Northern

Lincolnshire NHS Area are using Easy Care plus a multiplicity of trial from which to share learning the capacity and

creativity to create common training programmes

Sharing of templates, job descriptions and committee/board papers information sharing protocols will become more common across more boundaries.

• Driving towards a common IT infrastructure and architecture• The whole area is a sub set of the wider geography covered by NHS

Agent Accentua One common SAP linking product - Liquid Logic Common standards

across GP practices, Acute Trusts, PCTs with LAs recognising the benefits of being part of the solution. The common electronic record now becomes a tangible goal with SAP as its subset.

The test will be linking local authorities to this NHS Information Spine and the associated costs of this.

A recognition that success depends on having “a common mindset”

• User in the centre – a given.

• Common summary record ..a given objective

• Requires common standards and standardisation of approaches

• Common language• Shared skills• Shared perception of risk

• Requires new incoming staff trained in SAP principles and approaches

• All existing staff to be similarly skilled.

• Large investment required in training

• Regionally driven & co-ordinated.• Yet locally delivered.• Academically accredited yet

accessible to all

NEYNL – Proposed Virtual Learning Environment