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The number of fines for delayed discharges could be kept down if integrated services were 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 the sum invested.

While the charge can only be made to the local authority, the local authority and the primary care trust could agree that the cost of the fine should come out of a pooled budget.

- Go to www.doh.gov.uk/reimbursement/pdf/capacitypaper.pdf