2012JanAgenda4 - Royal Marsden Hospital

Royal Marsden NHS Foundation Trust Policy ()ACCOMMODATION FOR PATIENTS, RELATIVES AND CARERSSummaryThis policy covers the arrangements for the allocation of dedicated residentialaccommodation to patients and relatives on the Chelsea and Sutton sites. It addressescharging criteria and general rules of occupancy.CONTENTSSectionPage1 Introduction 12 Patients: Free accommodation 13 Notes: Patients Free accommodation 24 Relatives/Carers: Free accommodation 35 Notes: Relatives/Carers Free accommodation 36 Patients/Relatives/Carers: Accommodation provided with a 4charge7 Notes: Patients/Relatives/Carers Accommodation provided 48with a chargeGeneral Notes910ReviewLinked Documents551. Introduction1.1 There is a small amount of dedicated residential accommodation on both theChelsea and Sutton sites available for short-term use by pre-defined categories ofpatients, and, more usually, patients’ relatives/carers. The Chelsea accommodationis located in Dame Unity House, in Guthrie Street, at the rear of the main hospitalsite. It comprises 20 twin rooms, although at the time of writing this policy 10 roomshave been temporarily decommissioned for office decanting as a result of the majorredevelopment of the Chelsea site. The Sutton accommodation is located on theactual hospital site and is more limited, comprising 2 twin rooms and 4 singlerooms. Due to the much smaller amount of accommodation at Sutton, it is unlikelythat the hospital will be able to meet all requests for accommodation on this site.1.2 The charges are as follows:Chelsea (Dame Unity House)£50.00 per room/per night (twin room)£60 per room/per night (en suite)Sutton£40.00 per room/per nightCharges are reviewed annually and amended as appropriate.Authoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 1 of 7

Royal Marsden NHS Foundation Trust Policy ()1.3 The Facilities Directorate has responsibility for the letting of this dedicated residentialaccommodation.2. Patients: Free accommodation2.1 There are a number of occasions when dedicated residential accommodation maybe available for patients, as set out below in paragraphs 2.2 - 2.4. If so, there will beno additional charge levied for this accommodation. In respect of the categorieslisted in 2.2 – 2.3, the cost is deemed to be included in contracts with purchasers.Inpatients: Prospective in-patients who have travelled a long distance but whoseadmission is delayed by the hospital until the following day. Such persons will needto be sufficiently ‘fit and well’ and able to look after themselves. Accommodation isoffered on a ‘bed only’ basis, and no medical cover is provided. Examples of suchpatients are as follows:Patients who have had e.g. chest X-rays and blood tests and have been seen bythe medical team prior to a surgical list the following day (e.g. breast lumps) butwho do not require nursing care.‘Fit and well’ patients who come for tests on day 1 (e.g. EDTA), with the possibilityof starting chemotherapy on day 2, and who live a long way away.2.2 Outpatients: NHS outpatients resident in the United Kingdom undergoingradiotherapy or chemotherapy treatment and who live too far away to travel on adaily basis.For the purposes of this policy, such appointments must have:• A journey time (primarily by car) of more than 2 hours from home to the hospital sitewhere the radiotherapy treatment is being provided; or• a journey time of more than 90 minutes if travelling primarily by public transportfrom home to a London mainline railway station if attending the Chelsea site; orpatients who have:• a home address more than 60 miles away from the hospital site where theradiotherapy treatment is being provided.2.3 Patients Generally: Where clinical staffrecommend that a relative/carer be with thepatient to provide support and to aid treatment, or where the patient is taking part ina clinical trial.3. Notes: Patients Free accommodation3.1 Inpatients will not be discharged to the hospital’s dedicated residentialaccommodation for convalescence or rehabilitation.Authoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 2 of 7

Royal Marsden NHS Foundation Trust Policy ()3.2 Where patients/prospective patients are accommodated, the hospital will not beresponsible for their care, and will not provide medical or nursing cover. In an‘emergency’ situation, the patient or their carer is advised to call for help via 999.See section 8.9 in respect of the Trust’s Resuscitation Policy.Authoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 3 of 7

Royal Marsden NHS Foundation Trust Policy ()4. Relatives/Carers: Free accommodation4.1 There are a number of occasions when free accommodation may be available forrelatives/carers as set out below in paragraphs 4.2 - 4.4:4.2 Where a patient’s death is imminent, or the patient is critically ill, and arelative/carer wishes to stay close by. Under such circumstances theaccommodation could be on the ward itself, or on another ward area nearby, ratherthan in the hospital’s dedicated residential accommodation. The nature of thesecircumstances is such that it is inappropriate to specify specific criteria for eligibility.The Ward Sister/ Charge Nurse will normally decide whether accommodation isappropriate and make the ultimate decision as to whether it is possible to provideaccommodation on the ward or whether use should be made of the Trust’salternative accommodation in Dame Unity House in Chelsea or the relatives’accommodation in Sutton.4.3 Where relatives/carers are unable to meet the cost of travel (evidence of not beingable to meet travel costs will be taken as being on Income Support) or are on ‘lowincome’ as assessed by Social Services, in which case either the cost of theaccommodation is recharged to the Howell Bequest or travel costs are reimbursedby the Howell Bequest, whichever is the cheaper option.4.4 The Assistant Chief Nurse and the Divisional Nurse Directors will also havediscretion to offer accommodation without charge for one night only, with noongoing commitment but to be reviewed on a daily basis. See also paragraph 7.6.5. Notes: Relatives/Carers Free Accommodation5.1 Relatives/carers will not routinely be offered free accommodation because a patienthas undergone surgery and is spending their first night in the Intensive Care Unit.5.2 Relatives/carers will not routinely be offered free accommodation for more than 2weeks. This is in order to allow the same facility to be offered to otherrelatives/carers in a similar position.6. Patients/Relatives/Carers: Accommodation provided with a charge6.1 A charge is levied for accommodation as set out below in paragraphs 5.2 - 5.36.2 Relatives/carers and patients, including relatives/carers of patients from Gibraltar,the Channel Islands and the Isle of Man, and Private Patients not entitled to NHStreatment (but excluding those covered by paragraphs 2 and 4 above).6.3 Patients who wish to stay in Trust accommodation for personal convenience, eitherbefore an outpatient appointment or treatment, or whilst they are undergoingoutpatient treatment.Authoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 4 of 7

Royal Marsden NHS Foundation Trust Policy ()7. Notes: Patients/Relatives/Carers: Accommodation provided with a charge7.1 Precedence will be given to NHS patients’ relatives/carers. Relatives/carers ofprivate patients not entitled to NHS treatment, may be accommodated, on anequivalent charge to NHS patients’ relatives/carers.7.2 Cancellation charges of 50% of the daily rate will be levied on anyone who fails tohonour a booking if it means a room cannot be let. The only exception to this iswhere the booking has only been cancelled because the hospital has cancelled atreatment session (e.g. due to equipment failure, or blood counts outside treatmentparameters).8. General Notes8.1 The Trust undertakes to honour all bookings.Only one room will be offered per family group unless room supply allows (andthen only in very exceptional circumstances). The hospital will restrict the number ofoccupants of any given room to reasonable number, dependent on the size/layoutof the room and taking into account the needs of other residents, and health andsafety issues.8.2 The hospital’s dedicated residential accommodation is not generally suitable forbabies, toddlers or children: as a guide children are deemed to be under the age of18. In exceptional circumstances only, children may be permitted to reside in thehospital’s residential accommodation. Under no circumstances will babies, toddlersor children be allowed to reside in the hospital’s dedicated residentialaccommodation alone – even during the daytime - whilst the parent/guardian isundergoing treatment in the hospital.8.3 The hospital reserves the right to refuse requests for accommodation. It should benoted that there may also be occasions when accommodation is unavailable due tohigh demand. The hospital also reserves the right to ask any resident to vacate theaccommodation.8.4 Under no circumstances will animals be accommodated.8.5 The hospital will not be responsible for residents’ personal property/valuables. Itmay be possible for departing residents of Dame Unity House to deposit theirluggage in the Facilities Office at Chelsea for a few hours, following their ‘checkout’.8.6 All residents will be required to sign a formal indemnity statement in respect ofaccident/illness/injury and loss of personal property/valuables. Pre-bookedresidents will be required to check in and out at times which are convenient to thehospital, in order that the necessary administration may be completed. Contingencyarrangements will be in place for short notice/high priority residencies, which occurout-of-hours. This also means that the 017/022 Clinical Site Practitioners will haveAuthoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 5 of 7

Royal Marsden NHS Foundation Trust Policy ()the same powers of discretion out-of-hours as the Assistant Chief Nurse and theDivisional Nurse Directors (see paragraph 4.6 above).8.7 The hospital will not be responsible for the payment of any hotel bills incurred bypatients, relatives/carers or others due to the unavailability of hospital dedicatedresidential accommodation.8.8 Outpatients staying in the hospital’s dedicated residential accommodation whilstundergoing treatment once per week (e.g. from Gibraltar) may occasionally beasked to vacate in preference to patients undergoing daily treatment (e.g. forRadiotherapy). Note: Gibraltar patients are also accommodated in Calpe House,Battersea, which is run by the Gibraltar Health Authority.As previously stated, The Trust will only provide residential accommodation to ‘fitand well’ patients. The residential accommodation at Sutton is located within themain hospital building. Therefore the Trust provides a resuscitation service tothese premises in line with the Trust’s Resuscitation Policy. Dame Unity House atChelsea is not located on the hospital premises. Therefore the Trust does notprovide a resuscitation service to these premises. The Trust’s Resuscitation Policysets out the arrangements in respect of Dame Unity house:Patients and/or relatives that are in Dame Unity House will be responded to by a999 emergency ambulance. Each outpatient utilising Dame Unity House must bemedically assessed and deemed fit to reside in the facility. Any patient/relativestaying in the accommodation must be given a New Resident Information Sheetfrom Facilities explaining that in the event of an emergency, 999 should be called.The resident will then inform Main Reception who will in turn inform the Clinical SitePractitioner (022). The 022 will then decide if a porter is required to give access tothe London Ambulance Service. The Clinical Site Practitioner will assess thesituation and may attend or send a senior nurse to assist. If any patient is deemedmedically unfit to go back to Dame Unity House, they should then be admitted as aninpatient. The patient/relative will sign an indemnity form to show that they haveunderstood this. (Section 8.5.2, Resuscitation Policy).8.10 Full procedure notes are maintained by the Facilities Office at Chelsea for DameUnity House and by the Facilities Office at Sutton for the Sutton relative’saccommodation.9. Review9.1 This policy will be reviewed again in not more than 12 months.10. Linked Documents10.1 Resuscitation Policy – Trust WideAuthoring Department: Version Number: Author Title: Published Date: Authoriser Title: Review Date: 07/09/2011Uncontrolled if printedPage 6 of 7

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