Guardianship Training Day

Guardianship Training Day

On 14 February 2017, Allied Health and Nursing staff from the NNSWLHD recently attended a Guardianship Training day in Ballina hosted by the North Coast Primary Health Network.

Key learnings from the day included:

• A new NSW Health Guideline: – The Guardianship Application (GA) Process for Adult Inpatients of NSW Health Facilities see https://intranet.nnswlhd.health.nsw.gov.au/doc-lib/documents/all/the-guardianship-application-process-for-adult-inpatients-of-nsw-health-facilities/
• Development of the new guideline was part of the Whole of Health Program aiming to:
• Facilitate a patient-focused journey
• Reduce the non-medical reasons for long stay (people waiting for outcome of a GA)
• Improve the process and speed of GAs – to speed up discharge planning and reduce bed block
• The GA guideline includes resources and a clear flowchart to assist health staff know
• If a Guardianship Application is necessary, appropriate and required – considers issues of a patient’s capacity to make decisions
• How to record data, complete forms and track (using the Patient Flow Portal) the application process
• What reports and evidence is required for each Guardianship Application
• Who is responsible for assessing capacity and coordinating a Guardianship Application

Fact: Even if a patient has an appointed guardian/ substitute decision maker for health/ accommodation matters, if the patient refuses to agree to recommendations/ and or discharge options, an NCAT hearing can be requested to seek coercive functions (eg to go into care, or have a health treatment).

There is currently a 6-month pilot with a dedicated NSW Civil and Administrative Tribunal (NCAT) Guardianship Division facilitating expedition of hearings with a 21-day period from application to hearing and a 14-day turn around for the decision.  Click Here for more information.

The Capacity assessment must conclude if a patient can

• Take in the information
• Hold the information
• Weigh up the benefits, risks and consequences
• Communicate the decision.

Resources included in the NSW Health GA guideline include

• Report templates (SW, OT & medical report outlines for GA / capacity assessments)
• Flowchart for decisions about if and when to do a GA application
• Data capture – using the Patient Flow Portal
• Risk assessment procedures

Adapted from summary by Dr Lynne Ridgway (Clinical Neuropsychologist, Ballina Rehabilitation & NBIRS), lynne.ridgway@ncahs.health.nsw.gov.au