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Implementing the Implementing the Single Assessment Single Assessment Process across the Process across the
South West PeninsulaSouth West Peninsula
Basic awarenessBasic awareness
What is the Single What is the Single Assessment Process (SAP) ?Assessment Process (SAP) ?
Originated from the National Service Framework (NSF)Older People Standard 2: Person Centred Care -a single agreed approach to assessment for health /social care
-type of assessment is appropriate to needs
-agencies do not duplicate assessment
-effective contribution by range of professionals/agencies
-resulting in a single holistic service or care plan -contributed to and agreed by all (including the person)
In South West Peninsula SAP will cover all adults 18+ except mental health
Who will be using SAP? Who will be using SAP?
All health &social staff South west peninsula partnership All organisations using same tools and
eSAP system PCTs, Adult social care,acute trustsFor full list of partners see SAP website
““Don’t you people talk to Don’t you people talk to each other?!”each other?!”
National guidanceNational guidance
“Provides a rigorous framework that will lead to convergence of assessment methods and results over time irrespective of the tools chosen for local use”
What is an What is an assessment?assessment?
•involves the gathering of information about the health and social status of the user, analysisof that data, and the making of a professionaljudgement to meet the user’s need
•Within SAP this is carried out with the service user
SAP SAP 4 types of assessment4 types of assessment
Contact
Overview
Specialist
Comprehensive
Contact AssessmentContact Assessment
Not every contact needs one initial contact if needs recording multi-agency referral form basic personal informationdifficulties, risks & significant life eventsany staff member who is trainednot necessarily professionally qualified staff may be partially completed by one person
OverviewOverview
More detailed assessment At any stage in SAP More complete picture of an individual Incorporates core information Includes information on
providers/agencies Risk triggers Identifies need for further assessment
SpecialistSpecialist
Specific difficulties identified at contact/overview One or more specialist professionals Unstable,unpredictable or complex needs Specialist tools/scales/measures -each profession
Examples of specialist assessments : The SAP Health needs assessment (HNA) is the only specialist assessment in place across the SWP and on eSAP – other specialist assessments will be carried out on existing tools or using FACE second line tools but not on eSAP) – eg Care programme Approach for mental health , Housing, Speech & language etc
Comprehensive Comprehensive ( in the SWP a process not a tool)( in the SWP a process not a tool)
Contributions from different professionals / teams
Co-ordinated by appropriately skilled professionals
Evidence base for detailed care planning Includes all domains of overview / specialist Intensive & prolonged level of support /
treatment Complex care packages - e.g. intermediate/residential care
Care PlanCare Plan
Care is joint agency and identifies what care or treatment is in place and who is providing this.
Contingency plan for emergenciesDiary Sheet
Review Review
All care plans should have review date set A review should take place with the person
and their carer The review tool is to record this and set
next review date
Making the links with SAPMaking the links with SAP
Managing long term conditions
Falls
Mental health and specialties
Continuing Care/
Funded nursing care
IntermediateCare
Delayed discharge
Medicines
Fair access to Care (FACS)
Person centred
one assessment across health & social care it can impact on all this and more….
Projecting & Sharing Information Projecting & Sharing Information
Don’t you people talk to each other!Information can be shared providing the
service user has given written or verbal consent and this is recorded on:“Consent to share and protect your information form
Agreed protocol across the health & social care agencies in SWP
What is eSAP? What is eSAP?
SAP can’t work without IT! eSAP enables assessment and care plan
information to be stored electronically , shared with professionals across health and social care and sent to each other
This is possible using your own computer and your organisation's IT system
Web based browser- very safe & secure
Benefits of eSAP Benefits of eSAP Reduction in delayed transfers of care
-Improved communication and better access to information
Reduction in unplanned admissions-Better information should lead to improved risk management decisions and unnecessary admissions to hospital
Better use of workforce -Reduce duplication and staff time spent in recording.
-Easier and faster transfer of information between agencies.
-More appropriate use of skills Less faxing , photocopying, storage
Personal held record Personal held record This is a folder ( usually yellow) held in person’s
home and issued by PCT Contains SAP documentation, communication
diary and useful self-care information Enables professionals to communicate Service user and carer kept informed Useful for emergencies Will be flagged on eSAP so know it is in place Anyone can suggest one is issued providing meet
the criteria as follows:
Criteria for Personal held Criteria for Personal held record record
complex care packages delivered in own home
treatment and care by a number of practitioners / agencies
known to request frequent unscheduled care from their GP (including out of hours services) or their district nurse
have required a number of unscheduled admissions to hospital
at ‘risk’ of needing emergency care
managed for a ‘long term condition’ or ‘complex care pathway’
palliative diagnosis including malignant or non-malignant
Single Assessment ProcessSingle Assessment Process
For further information contact:
Heather Eardley/Jude Anthonisz/Bruce o’Connor
SAP Programme Team Email :[email protected]
Tel: 01392 687142
Website address: www.devon.gov.uk/sap
