Meeting of the Parliament 04 February 2016
I cannot stress enough the importance of carers being fully involved in the hospital discharge planning of the person for whom they care to ensure that appropriate support arrangements are in place before that person is discharged from hospital.
Following acceptance of my stage 2 amendment by the Health and Sport Committee, the minister confirmed his support for involving carers and asked to work with me to ensure that the amendment could be further developed, with the aim of having these stage 3 amendments in my name. I met the minister on three occasions to discuss the amendments and I also received his written comments. It is of course very important to ensure that there are no delays in hospital discharge as a result of amendments or for any other reason.
Amendment 39 removes section 25(4A) so that my stage 2 amendment is removed completely. However, the provision will now be in a new section on its own, which will give it more prominence, making it easier for members and others to see what it does, rather than having a number of amendments to a section, which would not be easy to follow.
Amendment 40 inserts a new section after section 25. The purpose, as set out in subsection (1), is for each health board to ensure that, before a cared-for person is discharged from hospital, it involves any carer of that person in the discharge planning. The duty is conferred on the health board; in practice, that duty will be implemented within the wider context of integration, in partnership with the local integration joint board and the local council.
Subsection (2) of the new section makes it clear that
“A health board fulfils the duty in subsection (1)”
by taking appropriate steps to
“inform the carer ... of the intention to discharge the cared-for person”
and inviting the carer
“to give views about the discharge”.
The carer is to be informed of the intention to discharge the cared-for person
“as soon as reasonably practicable”.
I welcome the minister’s assurance that further detail on that will be covered in guidance, which I hope that he will confirm today. Paragraph (b) of subsection (2) requires a health board to take account
"so far as it is reasonable and practicable to do so, of any views given by the carer in making decisions relating to the discharge of the cared-for person."
Subsection (3) qualifies the application of the section in that the health board must be able to identify the carer "without delay" and the cared-for person must be likely to require care following discharge. I hope that that will lead to dialogue with carers as soon as possible during the patient’s journey in hospital and avoid the current experience of many carers, who do not receive the information that they need on admission, diagnosis or discharge.
Subsection (4) defines “health board” and includes within the definition the State Hospitals Board for Scotland. Subsection (5) defines “hospitals” to mean
“a health service hospital”,
or,
“where a person receives accommodation or services in a hospital other than a health service hospital … such a hospital.”
Amendment 45 inserts a provision into section 36, on interpretation, to ensure that the interpretation of “health board” in this new section on carers’ involvement in hospital discharge of cared-for persons includes the State Hospitals Board for Scotland.
I move amendment 39.