We have independent providers who are looking for fee rises and who may well see local authorities under the threat of fines as easy targets for obtaining such rises. If the scheme is introduced in April 2003 there will be little time for last kronor costing and there will not have been any significant rebalance of the current continuum of care. The Department of Health offers the prospect of a standard tariff system that will introduce tighter pricing mechanisms into episodes of acute health care and give PCTs more levers for change.
However, this system is largely planned for introduction in 2004 and the Department of Health is committed to ensuring that there is no destabilisation of hospital trusts. This makes it all the more perverse to contemplate introducing a scheme that threatens the stability of social services. by placing all the risk of financial penalties on one agency that can pull only a few of the levers necessary to effect change. There are huge risks that the scheme will encourage partners to think that hospital admission is the route to care.
There is little to incentivise admission avoidance measures in the NHS, despite the evidence that up to 20% of admissions are considered to be avoidable if alternative services were available.It is known that problems with other interfaces within the hospital increase the length of stay and decrease the capability of a vulnerable older person. The focus on the discharge interface brings with it significant risk that effort and investment will be concentrated here rather than on the development. click here for details : Sydney Property Valuers
Range of whole system solutions that will offer more sustainable and better quality services in the longer term. An opportunity is being missed to establish a jointly owned performance framework around every critical aspect of provision across the health, housing, and social care agencies. The framework needs to be embedded in the National Service Framework for Older People and within the existing performance measures used within both the NHS and social services.