The number of fines for delayed discharges could be kept down if
integrated services are developed locally and risk shared among
agencies, according to guidance from the department of health.
The document states that one “alternative approach”
to the reimbursement system is for partners to agree to invest all
or part of the delayed discharges grant up front, with any
subsequent actual reimbursement which occurs being set against
against the sum invested.
In addition, while the charge can only be made to the local
authority, it could agree with the primary care trust that the cost
of the fine should come out of a pooled budget.
Care trusts could also bear the reimbursement costs, the
guidance said, pointing out that care trusts are assigned some
social services activities when they are set up which could include
liability for reimbursement payments.