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Welcome to year 3 of the National Audit of Intermediate Care (NAIC 2014)



Professor John Young, National Clinical Director for Integration and Frail Elderly, NHS England, has said:

Some solutions can be hidden in plain sight. Those of us closely connected with intermediate care will certainly see these services as an important part of the solution for our overheated health and social care system. Perhaps it requires a time of austerity and an ageing population for the potential of intermediate care to be drawn into focus. The National Audit of Intermediate Care provides this focus".

Report and Toolkit

The NAIC 2014 summary report was successfully launched at the National Conference. The online toolkit, commissioner and provider reports are all available to download as pdf documents.

Patient Reported Experience Measure (PREM) Open Question Analysis

The full analysis of the Patient Reported Experience Measure (PREM) open narrative question which asked “Do you feel that there is something that could have made your experience of the service better” is available to download here.

National Audit of Intermediate Care 2014 findings

The 2014 online benchmarking toolkit is now available to access here. The online benchmarking tool is only available to audit participants. To check if your organisation took part in the audit, scroll to the bottom of the page for a list of participants.

National Conference 2014

The third National Conference was held on Wednesday 12th November 2014 at The ICC in Birmingham and launched the findings from the NAIC 2014. The NAIC 2014 Annual Conference programme can be found here. The National Conference was attended by over 300 delegates from across health & social care. National speakers included Professor David Oliver, Kings Fund fellow & BGS President and Professor John Young, National Clinical Director for Integration & the Frail Elderly, NHS England. The presentations from the morning session are available to download here:-

The afternoon case study presentations are available to download here:- 

National recognition for NAIC HQIP - The Healthcare Quality Improvement Partnership (HQIP) has announced that the NAIC is to be included on the 2014/15 Quality Accounts list. It is mandatory for NHS Trusts to produce a quality account every year which details the provider’s participation in clinical audit. This means that providers must participate in NAIC, unless they have a sound rationale for not doing so. For more information about HQIP and Quality Accounts, including the reference to the relevant legislation, please see the Statutory and mandatory requirements for Clinical Audit guidance on the HQIP webpages.

NHS England - In addition, NHS England has endorsed the audit and encouraged CCGs and Providers to take part in NAIC 2014. A letter from NHS England expressing their support for participation in NAIC 2014 has been included in the marketing pack and is available here

Reference Costs - The Department of Health this year has been working with the NHS to produce reference costs for intermediate care services. We are pleased to report that DH has referenced extensively the work in the NAIC, and that the new reference costs guidance aligns with the NAIC definitions. For Trusts, this should mean that they are applying the same principles for the reference costs as for NAIC. The latest guidance on the reference costs for intermediate care can be accessed here.

NAIC 2013 outputs - A Highlights Brochure has been developed for NAIC 2013 and is available here. This covers the key findings from NAIC 2013 and developments for NAIC 2014.

Further information - For any further information on NAIC 2014, please contact Jessica Grantham of the NAIC Support Team or call on 0161 266 1909.

Julia Skelton, Director of Professional Operations, College of Occupational Therapists:

This report makes the case for urgent investment in services which provide intermediate care. There is a danger zone between the GP surgery and hospital and it is here that older people need support quickly to remain well and independent at home. The report illustrates the outstanding outcomes that can be achieved when this support is provided and how strongly people value these services. The evidence is clear; people need help to manage daily life, carry on with routines, occupations and the activities that matter to them. We hope to see the skills of occupational therapists and their allied health professionals used further in opportunities provided by the Better Care fund and more widespread access to vital intermediate care services.

Cynthia Murphy, Vice Chair, College of Occupational Therapists Specialist Section Older People:

This year’s audit sample indicates that more clients are being treated via home based Intermediate Care or re-ablement services than in Intermediate Care bedded units. In addition to being more cost effective, it means that an individualised client centred approach to care and therapy can be delivered in a familiar environment - minimising possible dependency created by time away from home. To ensure optimum delivery of Intermediate Care services, whilst reducing waiting times between assessment and service delivery, a review of skill mix within the teams is essential, factoring in extra travel time to clients’ homes. Urgent investment in Intermediate Care services is essential to enable older people to remain independent at home for longer, delaying the need for premature admission to long term care home

Professor Karen Middleton, Chief Executive, Chartered Society of Physiotherapy:

Our ageing population demands a fresh approach to the way in which health and social care is delivered going forward. Keeping older people mobile and independent is a top priority and, where properly integrated, community-based health and social care services do exist, they are delivering impressive cost savings to the wider NHS Physiotherapists are highly skilled at preventing unnecessary admission to hospital, supporting timely discharge and maximising independent living. The NAIC report confirms that this approach works. Where patients have been lucky enough to receive quality intermediate care, extremely positive patient outcomes are reported. But the report also highlights a worrying reduction in staffing levels across all service categories involved in delivering care closer to home. This makes no clear financial sense; it just places even more strain on the acute sector, leaves too many older patients stuck in hospital, sees an unacceptable number of people readmitted to hospital further down the line and ultimately robs them of the chance of leading a fulfilling and independent lives. Commissioners can and must do far more to ensure people retain, or regain their independence. Facilitating the development of more joined-up intermediate care schemes to deliver better outcomes for patients and relieve financial pressures elsewhere in the system would be a welcome starting point.

Dr Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing:

The report makes it clear that where intermediate care staff are able to deliver the important link between GP, social care and hospitals, patients are very satisfied with the care they receive. These links can prevent unnecessary hospital stays and provide valuable relief to overstretched wards. Despite the clear benefits of well-funded intermediate care there is evidence of a growing shortfall in resources - a perfect example of short-term thinking. Investing money in services which could keep people out of hospital will lead to long-term savings. Britain has an ageing population where demand for treatment of long-term conditions is increasing. It is not fair, or prudent, to expect patients to go to hospital every time they require care which could be delivered in the community or in their homes. The Government should be inspired by the positives in this report and learn from its warnings.

NAIC 2014 participants

For a full list of participatant commissioners and providers for NAIC 2014, please click the appropriate link: