Open List for Discharge to Assess

The Council is working on behalf of the Buckinghamshire Clinical Commissioning Group and the wider health and social care system to sustain a robust Discharge to Assess pathway through the commissioning of domiciliary care packages and placements in care homes.

Discharge to Assess (D2A) is a pathway which has been successful in reducing acute bed occupancy. It is designed to be a nimble process that facilitates the rapid discharge from hospital of a medically optimised individuals. This maintains capacity in acute and community hospitals to allow them to be able to respond to pressures whether these are related to seasonal pressures or the demands of Covid-19. This pathway enables assessment of long term needs to take place in a setting that is less restrictive than hospital and will ensure longer term packages of care and support are reflective of the person's maximum abilities. Some people may require this support for a period, up to a maximum of 6 weeks depending on the assessments.

Our philosophy in Buckinghamshire is Home First. Whilst most people will be discharged home without the need for any funded extra support, some will have care and support needs that require D2A domiciliary care. This will provide care and support at home whilst social care needs assessments and occasionally NHS Continuing Healthcare Assessments of eligibility are undertaken in a community setting. If discharge home is not possible due to safety or client need, a care home placement may be considered.

The duration of each service user's placement in the D2A package of care or placement will be determined by the time taken to identify long term needs and funding arrangements. For most service users this will be within two weeks but where CHC eligibility requires a full assessment this may be up to six weeks.

The Council is seeking to establish a list of Care Providers who would be willing to accept D2A clients. Care Providers will be required to complete various pass/fail to obtain access onto the list. When an individual requires a D2A placement, care providers will be selected from the list based on availability, the specific needs of the individual, affordability and accessibility.

At times, the Council may need to acquire a number of beds in one location. On these occasions a block contract may be offered to one or a number of care providers on the list. Care Providers will be selected from the list based on availability, the specific needs of the individuals, affordability and accessibility.

The Council are seeking providers of the following:

• Domiciliary Care,
• Residential Care
• Nursing Care
• Dementia Nursing Care
• Dementia Residential Care
• Care homes able to manage particular needs relating to mental health or spinal patients