Let’s get assessments and reviews back on track

Dr Gabrielle Silver, CEO

There have been numerous media reports over the last two weeks drawing attention to the issues around the reviews and assessments for older people discharged into the community under Covid-19 funding. A recent Guardian article highlighted the potential harm to vulnerable people caused through the use of easements by Councils under the Coronavirus Act. Here permission has been given to pause or stop assessments, reviews and some care with both Liberty and Disability Rights now raising concerns.

Liberty commented: “The government and local councils should be working to shore up – not weaken – support for disabled people, their carers and those who rely on social care during this pandemic. We need to come through this crisis the right way – with all of our rights intact.”

Obviously ceasing or delaying these reviews and assessments is concerning in terms of patient safety but they are also disrupting the flow of patients from intermediate care into permanent arrangements. It’s fair to say that the longer the system is in stasis the harder it will be to get moving again. And, as times goes on, so the environmental challenges increase. There are still concerns about management of Covid-19 infections in care homes, the financial viability of these homes and as we ease out of the peak of the crisis we will soon be faced with the challenge of potential further peaks and planning for winter. To be able to effectively manage capacity in the community we need to complete the reviews and assessments, so we know exactly what we are dealing with before the next phase hits.

The system and the workforce are bruised from the last weeks’ intensity. Moving forward brings new difficulties around resource management, workforce capacity and infection control. BAU activities e.g. face-to-face assessments feel new and different when they need to be undertaken remotely. But we know from the work we are doing with CCGs that remote assessments can work well – even in complex cases.

It is imperative we push ahead with these assessments. Without them the system is frozen at a time when it desperately needs clarity around capacity and finances. And most importantly we have a duty of care to do the right things for older people currently in care, as well as those that will come into care in future months.

Jennifer Dixon, CEO of The Health Foundation, said in her statement to the Health Select committee last week: ‘COVID-19 has also demonstrated how the health and care system can move fast, implement new technology and ways of working, and the deep commitment of NHS and care staff. All of these will be needed, with resources to match, to face the challenges ahead’.

I would echo her points and add that private sector partners are critical to getting the system moving. The NHS and Social Care systems are not islands and nor should they be. It’s time to embrace the breadth of the sector – and that means all of the knowledge, innovation and capacity that exists in private sector as well. We are here to help for the benefit of all stakeholders.