Multidisciplinary team working can help prevent people with social care needs from staying in hospital unnecessarily, according to the National Institute for Health and Care Excellence (NICE).
NICE calls for good communication and information sharing between health and social care professionals
Its guidance says hospitals should bring a range professionals together whenever someone with social care needs is admitted.
Pressure on beds should not result in unplanned or uncoordinated discharges, the guidance says. NICE calls on commissioners of health and social care services to develop multi-agency plans to tackle pressures on services, including bed shortages.
The document’s recommendations for good communication and information sharing include
- Health and social care professionals must record and share information about patients electronically, so that it is accessible to everyone providing care.
- Community-based multidisciplinary teams should maintain contact with people after discharge by making regular phone calls and home visits, for example.
- People receiving care should know how to contact their community-based health and social care team after leaving hospital.
- When discharge planning, coordinators should share assessments and updates on a person's health status with members of both hospital and community-based multidisciplinary teams.
Natalie Beswetherick, the CSP’s director of practice and development, said: ‘The document brings together a range of existing NICE guidance. It reinforces the importance of robust communication between multidisciplinary teams throughout the pathway.
‘This includes offering people early supported discharge with community support and rehabilitation – very welcome given the current pressures on bed occupancy.’
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