Independent Transfer of Care Co-ordinators

The Independent Transfer of Care will: Support and facilitate timely and safe discharges from hospital to care homes Undertake assessments and re-assessments on behalf of the care homes Ensure the discharge documentation was complete to accompany the resident on discharge Liaise with the care homes about the discharge arrangements to streamline processes Act as a point of contact when residents are admitted to hospital to monitor progress Work in partnership with care homes and the hospital to find solutions to current challenges Implement service improvements ongoing to improve processes and systems for the benefit of service users and key stakeholders Pro-actively maintain networks with care providers and key stakeholder to inform service improvements The aim of the service is to reduce the waiting time and the number of people awaiting discharge from hospital by coordinating a speedier, efficient and safe transfer of care from acute setting to residential or nursing care in the community.