Select Committee on Health Minutes of Evidence


Annex 7

DELAYED DISCHARGE LEGISLATION

The Community Care (Delayed Discharges etc) Act 2003

  1.  Patients receiving palliative care may have a strong preference to return home or to be cared for in a more homely setting than a hospital or hospice. This choice should be the guiding principle in discharge planning and community services should be put in place quickly if the person wishes to return home. Patients who receive palliative care should meet local criteria for fully funded NHS continuing care and their care package will be the responsibility of the NHS. Guidance on fully funded NHS continuing care, published in June 2001, makes it clear that "Patients who require palliative care and whose prognosis is that they are likely to die in the near future should be able to choose to remain in NHS funded accommodation (including a nursing home) or return home with appropriate support. Patients may also require episodes of palliative care to deal with complex situations (including respite care) and the number of episodes required will be unpredictable. The application of time limits to this type of care is not appropriate." This makes it clear that it must be the level of need for care, which is the criteria for NHS responsibility, not an arbitrary time limit.

  2.  Patients receiving palliative care, for example in hospices or palliative care units, are currently excluded from the definition of acute care within the Community Care (Delayed Discharges etc) Act 2003, because in many cases they continue to be the NHS's responsibility whichever setting they move to. This does not mean that their discharge should not be planned according to good practice as outlined in Discharge from hospital: pathway, process and practice, published in January 2003. Further information on good practice will be included in the NICE supportive and palliative care guidance.



 
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