Belfast Health & Social Care Trust
Resettlement of Patients from Muckamore
Interim Guidance for Staff (in conjunction and agreement with Finance Staff)
Patients Community Resettlement
The following is interim guidance until full agreement has been reached with RQIA, Office of Care and Protection and Finance as to final management of patients monies both during initial stages of resettlement and final discharge. The final guidance will be incorporated into the written procedures for the management of patients’ monies. This guidance only applies to those patients who are being resettled and are deemed to be incapable of managing their own financial affairs.
Assumptions:
The Multidisciplinary team alongside Care Managers meet to discuss the resettlement of patients. At these meetings and in conjunction with families there will be discussions on what is considered to be the facility most suited to meet the needs of the patient.
a)At this meeting, Finance stafffeels it is important to discuss the financial implications of the resettlement for the patient.
b)As part of this review of the patient’s finances, money set aside if practicable for the following types of expenditure prior to disclosing financial information to external organisations e.g. Housing Executive etc
i)Funeral Plan
ii)Furniture if going into supported living (Care Manager’s will have responsibility to
ensure that all expenditure in this respect is both reasonable and necessary)
Trial Resettlement
Whilst the patient is on a trial resettlement, Finance recommends that the appointee ship and benefits remain with Muckamore Abbey Hospital. In order for the patient / external organisation to access these finances the following is proposed:
If the financial implications of the resettlement are discussed at the resettlement meetings, there should be a good understanding of what the financial impact is for the patient. Therefore hospital finance staff can release the following if it is addressed at the resettlement meetings.
i)Rent for Supported living if the patient is eligible to pay, i.e. has more in their personal account than the threshold for payment allows.
ii)If a patient requires daily living cost monies while on Trial Leave, the facility to which they are resettling must request in writing from the care manager/social worker the amount that is required for the patient. The facility should as far as is practicable indicate what the monies are to be used for.
iii)The care manager/social worker will sign the request and forward to Hospital Finance for payment of a cheque to the facility. Hospital Finance will forward the cheque to the facility. The cheque will have to be paid into the facility’s business account as the patient will not have a personal account at this stage. Each facility will have a responsibility for ensuring that it has robust internal accounting procedures for patients’ personal spend.
iv)When Hospital staff use the current Form 2 to withdraw monies for a patient who is going out on resettlement, they must make an entry into the patient’s ledger stating that this was withdrawn for the purposes of trail resettlement. This should also be clearly indicated in the column “Purposes” on the Form 2.
v)The facility will be responsible for all receipting of the patients’ monies. Corporate Finance staff will have the responsibility for inspection of receipts in all community facilities.
vi)Payment to other Trusts for placements in Residential & Nursing accommodation. The care manager or in the absence of the care manager, the social worker identifies the cost of the trial resettlement placement so that the provider can send the invoices for this direct to the care manager/social worker who will sign off and forward to the hospital finance staff for payment. This will remove the difficulties there has been to date with invoices being constantly late for payment. All third party providers need to ensure that their bank details are included on all invoices submitted for payment – On-line payment transfers can be completed within 24-48hours if requested, again bank details need to be included on all invoices submitted for payment.
vii)Finance will release the money on these instructions without the need to go back to the discharge ward for approval. If a request for expenditure is significantly higher than was planned in the resettlement meeting then Finance will request additional information from whomever is requesting the money and liaise with the patients care manager/social worker to ascertain if the expenditure is reasonable before they release the money.
Permanent Resettlement
If the patient is eventually resettled on a permanent basis,the following should happen with immediate effect:
i)Appointeeship should be relinquished by Muckamore and transferred to the Trust with the responsibility for this patient. In the case of the Belfast Health & Social Care Trust appointeeship will transfer from Muckamore to Patient / Client accounting where the manager is the Trusts corporate appointee for patients / clients who are in the community.
ii)Savingswill automatically be transferred to the relevant Trust except for the Belfast Trust where the patient’s savings will remain and all future benefits will continue to be managed by the Belfast Trust.
iii)All future releases of money from the patient accounts will be in consultation with their Care Manager/Social Worker or Community Worker.
iv)Any additional costs incurred and identified by the Belfast Trust after the patient has been discharged will be invoiced directly to the Trust to which the patient has been discharged.