Single Assessment Process

1
Single Assessment Process

• Regional Overview from
• North and East Yorkshire and Northern
  Lincolnshire
• SAP Learning Consortium.

2
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

3
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

4
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

5
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

6
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

7
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

8
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

9
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
10
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

11
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!

12
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

13
Moving Forward and making it happen finding
solutions.

• Working in focussed specific areas
• Teams where patient/user flows are shared
• Hospital discharge p Mental health teams
• Learning disability teams, p 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 p Linked to a
  hospital ward or rehab unit or p particular rural
  area.

14
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 p the capacity and creativity to
  create common training programmes
• Sharing of templates, job descriptions and
  committee/board papers p 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
  p Common standards across GP practices, Acute
  Trusts, PCTs with LAs recognising the benefits of
  being part of the solution. p 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.

15
A recognition that success depends on having a
common mindset

• 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

• 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

16
NEYNL Proposed Virtual Learning Environment