Older people transferring from NHS hospitals to independent sector nursing homes need continuity of care. However, nurses in the NHS and independent sectors are often out of touch with each other. In the second of two articles on discharge and older people, the author discusses the need for education, assessment and effective communication to help nurses, wherever they work, to provide effective care for elderly people. The author describes an assessment scale for physical and mental abilities, developed to assist the transfer process. The first article was published in Nursing Standard (Nazarko 1998)

A quarter of 85-year-old and half of 90-year-old people live in residential care (DoH 1997). Many older adults discharged from hospital are transferred to independent sector homes. People entering long-term care, and their relatives, often ask nurses what homes are like and what type of care they offer. Medical staff often rely on nurses to advise them when a patient can be discharged back to the nursing or residential home. Care managers often ask nurses about the level of care provided in local nursing homes. Yet many of today’s senior ward nurses qualified more than ten years ago (Seccombe and Smith 1996) before independent sector homes were commonplace. Many hospital nurses do not know the range and levels of residential care available (Nazarko 1991). Independent sector nurses trained in NHS hospitals may not appreciate the impact of the changes in the NHS. Nurses who want to provide high quality care must work together to break down the barriers that separate state and independent sector care.