Paul Calaminus Chief Operating Officer & Deputy CEO Administrator. Emilia Marchitto Executive Assistant

Transcription

1 Meeting Name: Discharges & Accommodation Steering Group Date: Tuesday 1 March 2016 Time: 16:00 17:00 Venue: Executive meeting room 3, 4 th Floor, East Wing Chair Paul Calaminus Chief Operating Officer & Deputy CEO Administrator Emilia Marchitto Executive Assistant 1. Present- Paul Calaminus (Chair), Emilia Marchitto (Minutes), Michelle Murray, Ruth Appleton, Wendy Savage, Karen Jones, David Robertson & Dr Petros Lekkos. Apologies Ian Griffiths, Diana Brown & Thomas Hudson. 2. Welcome & Introductions Introductions were made and Paul briefed on what the group will be focusing on. Paul added that more staff have shown in interest in attending this work stream and that he has also written to the housing local authorities and the directors of public health asking if there is any interest of joining or if any nominations can be made to join this group. The following points were made during the group discussion: Impact of homelessness and people without a fixed abode. Difference between Trust process for finding accommodation for patients, and the council process for finding accommodation for vulnerable people. Impact of a hospital stay on accommodation, especially if people were in temporary accommodation just prior to admission. Some people may find their placement cancelled after admission. Paul is currently counting bed days used up by accommodation issues, where patients are fit for discharge. 3. Discharge from Hospital/Homelessness & Mental Health in Camden & Islington Governors Motion Paper This was a paper which was presented at the last Governors meeting on the 12 January This paper was agreed at the group. This paper is attached as appendix Terms of Reference (ToR) Paul and the group went through the ToR for this group and the works teams which need to be put together: To oversee a review of the issue of homelessness and mental health in Camden and Islington, with progress to be reported back to the Council of Governors in due course. To identify any funding opportunities through the Better Care Fund and develop proposals for funding. To review the operation of discharge co-ordination, including the operation of the role of discharge co-ordinator. To consider whether there are issues relating to the discharge of service users who are asylum seekers and for these to be taken into account as well. Terms of reference paper attached as appendix 2. Page 1 of 2

2 1. Work Plan The group brainstormed some ideas on what the work plan should include: Step down placement for patients well enough to be discharged for a period of time with a full discharge team who will visit people in the community/step down to provide nursing/psychology/advice and advocacy. Having a definition of being homeless and what the requirements are around being homeless. Suggestion of protocol papers being circulated. Action: Protocols paper to be sent out. A suggestion was made around getting an understanding from both Camden & Islington boroughs on what their definitions and requirements are on being homeless etc. Having different options on obtaining hostels etc. for mentally ill homeless people. Finding out the number of bed days currently relating to people delayed because of accommodation. Action: Karen Jones. Suggestion of looking at the UCLH Pathway in more detail. Action: David to get a contact name and number so that the group can liaise with them. Looking at half way houses or supported hostels for vulnerable people. Having a Housing benefit changes & rent changes work stream. 2. Actions The following actions were suggested: 1. Link with hostels in Camden and Islington: Mental Health hostels. Could we fund nursing, psychology, etc., into hostel teams; so that people are discharged with support. Can't discharge over the weekend if people are NFA. 2. Fact finding exercise with UCH to look at their pathways for people who are NFA, especially with regards to step down hostels with nursing care: Can we find out what other NHS Foundation Trusts are doing with this issue? 3. Draft a report on frequent scenarios: Common examples of cohort of patients facing difficulty in getting accommodation upon discharge. 4. Issue of community mental health clients who are discharged from mental health services, where their right to accommodation is tied with their mental health status. For example, asylum seekers have 28 days to find alternative accommodation once they are discharged from their CMHT. They also lose their food vouchers. Clarify this with the relevant councils. 5. Establish links with decision makers in Camden and Islington councils. 6. When will we have a best estimate of bed days occupied by people who are delayed discharge from hospital during the last quarter/year due to no accommodation to go to. 7. Assess the likely impact of the Housing Benefit Changes on the issue of patients NFA on the wards. 6. Next Meeting Thursday 21 April 2016 at 4pm Executive meeting room 1, 3 rd floor, east wing, SPH. Page 2 of 2

3 Appendix 1 Council of Governors Governor Motion Motion Concerns: Discharge from Hospital / Homelessness and Mental Health in Camden and Islington Date of Council meeting: 12 January 2016 Motion raised by: Ms Michelle Murray, Camden Public Governor The following issues are presented to the Council and their support is sought in supporting this motion which makes a number of requests of the Trust: 1. I believe there is a developing problem with regard to homelessness and Mental Health in Camden and Islington. 2. I further believe that there is a particular issue regarding the timely discharge of recovering Service Users, who, as they are homeless, do not have an appropriate context into which they can be discharged, and so are delayed in their discharge, or at high risk of readmission. 3. I ask the Council of Governors to support a REQUEST that the Trust Board take measures to contact Camden and Islington with a view to setting up a joint review of the issue of homelessness and mental health in Camden and Islington, with progress to be reported back to the Council of Governors in due course. 4. I further ask the Council of Governors to support a REQUEST that the Board investigate whether funding to address this issue could be obtained through the Better Care Fund through the Joint Commissioning Committee in Camden and Islington, and if relevant put forward definite proposals as to how this money could be spent. 5. I also ask the Council of Governors to support a REQUEST that the Board seek other solutions, or establish other mechanisms to resolve the problem. For example, the Board might wish to consider appointing a discharge coordinator to be put in post to deal specifically with delayed discharges and the discharging of people of no fixed abode, as soon as possible for a trial period of six months to see the efficacy of such a dedicated resource. Were this course of action, or a similar one, to be adopted, the timescale of the trial to be reported back to the Council of Governors, with the hope that this be soon and even by the end of January Finally, I ask that the Council of Governors to also consider whether there are issues relating to the discharge of service users who are asylum seekers and asks for account of this to be taken as well.

4 Appendix 2 Discharges & Accommodation Steering Group Terms of Reference (Revised February 2016) 1. Role The role of the Discharges & Accommodation Group is: To oversee a review of the issue of homelessness and mental health in Camden and Islington, with progress to be reported back to the Council of Governors in due course. To identify any funding opportunities through the Better Care Fund and develop proposals for funding. To review the operation of discharge co-ordination, including the operation of the role of discharge co-ordinator. To consider whether there are issues relating to the discharge of service users who are asylum seekers and for these to be taken into account as well. 2. Membership 2.1 The membership will be as follows: Chief Operating Officer/Deputy Chief Executive; Clinical Director, Acute Division; Team Manager, Acute Division; X 3 Trust Governors; Consultant Psychiatrist, Acute Division; Occupational Therapist; Deputy Manager, Isledon Road; and Assistant Practitioner, Assertive Outreach Team. 3. Secretary 3.1 Emilia Marchitto, Executive assistant to the Chief Operating Officer & Deputy Chief Executive (Chair of the group) will provide administrative support to the Group. 4. Quorum, Structure and Specific Function 4.1 The quorum necessary for the transaction of business shall be five members, one of which will be a Trust Governor. 4.2 A duly convened meeting of the Group at which a quorum is present shall be competent to exercise all or any of the authorities, powers and discretions vested in or exercisable by the Group. Page 1 of 2

5 Appendix 2 5. Frequency and length of Meetings and Attendance Requirements 5.1 The Group will meet every four weeks and at appropriate times in the reporting cycle and otherwise as required. 6. Notice of Meetings 6.1 Unless otherwise agreed, notice of each meeting confirming the venue, time and date together with an agenda of items to be discussed and any supporting papers, shall be forwarded to each member of the Group, and any other person required to attend, not less than 3 working days before the date of the meeting. 7. Minutes of Meetings 7.1 Administrative support will be available to minute the proceedings of all meetings of the Group, including recording the names of those present and in attendance. 7.2 Members and those present should state any conflicts of interest and the Secretary should minute them accordingly. 7.3 Minutes of meetings will be circulated within one working day to the members and any other relevant parties. 8. Duties 8.1 The Group should carry out the duties below for the Trust, as appropriate. A working group be established to review all available data sources relating to this issue, and to ensure that any other required data is collected, and that this group be tasked with reporting back to the Board (via the Foundation Trust Executive) on the impact of homelessness on discharge from hospital, and any proposals to improve the provision of services for this group. It is also proposed that representatives from the local authorities be invited to attend this group, with a view to scoping any potential input from local authorities (such as through the Better Care Fund) into improving provision for this group of service users. Feedback on the enhanced role of discharge co-ordinator should be provided to this steering group on a regular basis, in order to provide assurance that issues are being addressed, and that any more systemic issues that the working group might usefully consider are appropriately brought to their attention. 9. Other Matters 9.1 The Group should have access to sufficient resources in order to carry out its duties. 10. Reporting Responsibilities and Committee Structure 10.1 The minutes of the Group will be presented to the Trust Board. 11. Authority 11.1 The Group will operate in line with relevant laws and regulations, the Trust s Standing Financial Instructions (SFIs) and other Trust policies. 12. Monitoring and Review 12.1 The Secretary will assess agenda items to ensure they comply with the Group s responsibilities The Group will, at least once a year, review its own performance, membership and Terms of Reference to ensure it is operating at maximum effectiveness and recommend to the Trust Board for approval, any changes it considers necessary. Page 2 of 2