Our intermediate care and reablement event took place at 200 St Vincent Street on 21st March 2017 and shared findings from our intermediate care scoping work, and learning from services across Scotland. The event was supported by the Scottish Government, Social Work Scotland and the Health and Social Care Benchmarking Network.
Isla Bisset from the Scottish Government presented data on delayed discharges from January 2017, and Deanna Campbell gave an overview of the intermediate care minimum dataset, which records different interventions, their impact, and whether an anticipatory care plan was in place. Outcomes included avoided hospital admissions and early supported discharge.
Dr Graham Ellis discussed the evidence base for intermediate care, rating the quality of evidence for different interventions. While there is strong evidence for interventions such as step down beds and community rehabilitation, others such as discharge to assess and reablement have emerging evidence, and further studies are needed in these areas. Graham highlighted a number of enablers for intermediate care:
- Risk prediction tools
- Single point of access
- Information Management (and technology)
- Workforce development
- Shared Budgets
- Anticipatory Care Planning
Lianne McInally, Improvement Advisor, discussed the findings from our intermediate care scoping work, which explored the services that are available across Scotland. Chief Officers and their representatives from the 31 health and social care partnerships (HSCPs) were invited to take part in the intermediate care and reablement scoping, which comprised an online survey and an interview about intermediate care and reablement within their partnership area.
She highlighted priorities for HSCPs, including tackling delayed discharge and a focus on prevention, and developing a holistic support to service delivery. Challenges with intermediate care and reablement services included finances, workforce training and change management.
Our intermediate care atlas provides an overview of the intermediate care and reablement services that are available across Scotland.
Dr Thomas Monaghan, Living Well in Communities Portfolio Lead, gave an introduction to evaluation and outlined the benefits of logic modelling. Intermediate care and reablement services can struggle to evaluate their services in order to sustain funding. It can be difficult to demonstrate impact of an intervention in community setting due to the large number of variables, and logic models can help to construct a plausible story that commissioners can see.
Our world café session offered delegates the opportunity to learn more about good practice from across Scotland. We had brief presentations on the following topics:
- Intermediate care and technology
- Hospital at home
- Adults with incapacity
- Intermediate care in Mid Lothian
- Rehabilitation cottages
Our afternoon workshops gave an overview of the whole Living Well in Communities portfolio, shared findings from the Health and Social Care Benchmarking Network’s (HSCBN) reablement report, outlined the development of the Indicator of Relative Need (ioRN) tool and explored the Glasgow care homes model of intermediate care.
The Living Well in Communities workshop highlighted our work across frailty and falls, anticipatory care planning, palliative care and neighbourhood care.
The ioRN session showed how ioRN groups can help people to understand who is being referred into a service, and how ioRN data can be used to demonstrate how the characteristics of care home residents have changed over time.
The session on the Glasgow care homes model of intermediate care described the development of an integrated care pathway for older people and a model of intermediate care beds in Glasgow, and emphasised the importance of building relationships across sectors.
Overall this was a very interesting day which highlighted the breadth and variety of work by intermediate care and reablement services across Scotland.