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The Single Assessment Process

Over the last 25 years the number of people aged over 65 has doubled. Nearly half of all health and social care resources are taken up by services for older people


Why a Single Assessment Process?


  The Single Assessment Process is intended to improve both the quality and consistency of care

It is a unified system for people who have complex and/or multiple care needs

A €˜one-stop€™ service for those needing more than one type of service



  If €˜continence€™ is seen as a voluntary action in socially acceptable circumstances then €˜incontinence€™ is any variation from this

Many people do not consider themselves incontinent but do experience leakages from the bladder or bowel


The NSF for Older People


  The National Service Framework for older people was published on 27 March 2001

It set new national standards and service models of care across health and social services for all older people

These standards and models of care apply to all older people – whether they live at home, in residential care or are being looked after in hospital



The NSF for Older People €“ Standard 2


What is the aim of this standard?

To ensure that older people are treated as individuals

To ensure that they receive appropriate and timely packages of care

To ensure that these packages of care meet their needs as individuals, regardless of health and social services boundaries


€œNHS and social care services treat older people as individuals and enable them to make choices about their own care. This is achieved through the single assessment process, integrated commissioning arrangements and the integrated provision of services, including community equipment and continence services€      (DoH March 2001)




Why a Single Assessment Process?

  Cuts €˜red tape€™

Saves older people from providing the same personal details/discussing their needs with a range of different agencies

Ensuring the older person€™s needs and wishes lie at the heart of the process



  The Single Assessment Process was fully implemented in April 2004

Older people receive a multidisciplinary, interagency assessment of their needs

So that they receive relevant services in an integrated way


The NSF for Older People €“ Standard 2 €˜Person Centred Care€™


Treating older people as individuals

Enabling older people to make choices about their own care


Person Centred Care

  The older person and their family/carer are central to the process

Person-centred care recognises that the older person is the expert on their own situation

Their views and wishes must be explored in partnership with professionals so that suitable care provision is offered


Person Centred Care €“ User and Carer Views


  Prior to implementation of the SAP views were obtained from users and carers

Consultation was undertaken by both the NHS and Local Authorities

Views/satisfaction levels based on individual experiences were collated via surveys


What Does Person Centred Care mean to a Service User?



  Avoid jargon

Avoid assumptions

Treat me as unique

I need accessible information

My issues are important to me

Allow me enough time to talk

Find out about my background

Explain things simply

Protect my interests

Send me letters I can understand

Recognise the contribution of carers

I don€™t want to keep repeating myself


What Does SAP Actually Mean?

  A single approach to assessing health and social care needs

Assessment is proportional to needs

No duplicate assessments by different agencies

There is a single holistic service or care plan

All agencies contribute

The views of the older person and their carers are central

The sharing of information appropriately

Not overlooking needs

Further developing joint working between agencies


Who is Involved in the SAP?

  Users and Carers

Voluntary Sector

Primary Care, Acute Trusts, Mental Health

Adult & Community Care Services

Borough Councils Housing & Community Services

Ambulance Service



Making the SAP Work

  Common shared values

Common terminology & tools

Acceptance of someone else€™s assessment

Key worker responsibility

A thorough understanding of services

A person-centred approach

Effective sharing of information


Before the SAP . . . . . . . .

  Limited information available for a thorough assessment

Older people were not at the centre of assessment and care planning

Treatable health conditions were missed/ misdiagnosed

Insensitivity to race and culture

Assessment was not in proportion to an older person€™s needs

Assessments were duplicated and information not shared

Professionals did not always accept each other€™s  assessments