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Descriptions

South East Staffordshire & Seisdon Peninsula CCG is seeking expressions of interest to deliver an intermediate care service to the population. The CCG has taken an innovative approach to the design of this unique service specification, actively engaging with patients and listening to the desired outcomes of real service users to ensure the needs of the population are met. The CCG would welcome expressions of interest from forward thinking providers who would like to take on this exciting challenge.The following definition of Intermediate Care is used for this service:‘A range of integrated health and social care services which aim to promote faster recovery from illness, prevent unnecessary acute hospital admission and premature admission to long term residential care, that supports timely discharge from hospital and maximises independent living’.The aim of the service is to treat and support people in times of health or social care crisis to avoid hospital admission, and to support people following an inpatient episode.Objectives:— The Provider shall deliver responsive care to meet service users' needs;— The Provider shall ensure where appropriate service users are safely supported in their usual place of residence during acute illness/crisis;— The Provider shall work with service users to maximise their independence;— The Provider shall support service users to return to their optimal level of functioning;— The Provider shall support service users to self-care;— The Provider shall support service users to adapt to disease progression and decline in health/ independence;— The Provider shall ensure service users and their families/carer feel part of the care process;The levels of service provision are described below:Level 1 — Fast Track Comprehensive Geriatric Assessment — A specialist medical assessment of frail older people that supports prevention of future hospital admissions;Level 2 — Intermediate Care Step Up — A range of personal care, clinical and therapy assessment, diagnosis and treatment either in the service users’ usual place of residence or a bed based facility to prevent hospital admission.Level 3 — Hospital Discharge Planning — A clinical review and facilitation of service users' discharge, as soon as they are medically stable. This includes service users in either Emergency Departments or Hospital Wards;Level 4 — Intermediate Care Step Down — A range of personal care, clinical and therapy assessment, treatment, rehabilitation and reablement, either in the service users’ usual place of residence, or a bed based facility. This will support acute hospital discharge, recovery from illness and increase independent living.The population utilises services from 31 GP Practices, three Community Providers, two Mental Health trust and four main hospital providers, three of which are classed as out of area (i.e. out of Staffordshire).The anticipated start date is 6.7.2015.The Provider will be notified by March 2015 to enable implementation.The procurement will have TUPE implications.