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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