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Single Assessment Process - localities, 'good practice' and innovation

The following listing is subject to ongoing review and revision...

Bedford Hospital NHS Trust
This Trust has developed and implemented SAP training programme using specially developed training packs and facilitators a range of training materials is available. Training is two tier. (1) Training the trainers - 'champions' who looked at theoretical issues around SAP, consent issues, and more. (2) Practical training of all the professionals - mixed groups of practitioners - developed training manual with exercises, case scenarios for multiagency audiences. Intensive training programme over 2 months. Trainees received certificates I and II after completing the work.
Contact details:
Jenny McAteer, Operational Lead SAP, Bedfordshire Social Services Adult Team, Kempston Road, Bedford, MK42 9DJ
Tel: +44 (0)1234 355122 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Bedfordshire and Luton (Bedfordshire County Council, Luton Borough Council)
Bedford has developed and implemented SAP training programme using specially developed training packs and facilitators. Paper based assessment at present. The use of a "personal held record" is the key record and a copy is held by the client as well as social services but a duplicate is not held with the health authority (as according to the Royal College of Nursing). SAP document available for download -$single_a/$file/single_a.pdf [website chk links broken] 1/12/08 kj
Contact details:
Linda Coady, SAP Lead - Luton, Luton Borough Council, Housing and Social Services Dept, Community Care Duty Team, Clemitson House, 14 Upper George Street, Luton, LU1 2RP
Tel: +44 (0)1582 547659/547660 (switchboard) +44 (0)1582 470900 Sue Bird |  Fax:  |  E–mail:  | 
Other Contacts: Sue Bird, Operational Lead on SAPS
Web link(s):$single_a/$file/single_a.pdf

Blake Lapthorn Linnell
Blake Lapthorn Linnell is one of the largest leading law firms operating in the South East of England with offices in London, Southampton, Winchester, Oxford, Fareham, Portsmouth. They have a Health and Care team which specialises in residential care. There is a care home newsletter (May 2006) produced on contracts with residents in care homes available from their website. A newsletter will be produced on other specific topics on an occasional basis. Nigel Craig has particular expertise in residential care.
Contact details:
Nigel Craig (Partner) Holbrook House 14 Great Queen Street London WC2B 5DG
Tel: +44 (0)23 9228 2755 +44 (0)20 74301709 (London) |  Fax:  |  E–mail:  | (for newsletter)
Other Contacts: John Parkinson (tel: 01489 555044) (newsletters/briefings)
Web link(s):

Buckinghamshire County Council
The website provides information on SAP in Bucks through a Frequently Asked Questions format. A series of SAP workshops have been completed and the powerpoint presentations can be viewed through a web link. The workshops were aimed at people who work in health, social care or the voluntary sector and members of the public who were interested in finding out how the Single Assessment will affect older people. If you would like further information on the workshops you can call the NSF and Single Assessment Assistant on 01296 382550. [ webpage link broken so replaced with current link 1/12/08 kj]
Contact details:
Kerry Stevens, NSF and SAP Coordinator, County Hall, Walton Street, Aylesbury, Buckinghamshire, HP20 1UA
Tel: +44 (0)1296 395000 x3927 +44 01296 383204 (direct) |  Fax:  |  E–mail:  |
Other Contacts:
Web link(s):

Cambridgeshire Social Services
Cambridgeshire County Council's Social Services and health care providers in the county joined forces to create the Cambridgeshire Assessment Tool (CAT) initially as a paper-based system providing a single source of information on the care needs of older people. The CAT developed into an electronic system based on hand-held computers that enable all staff to gather the information needed to gauge the help and support needed in a single visit. Referrals for more specialist services can also be made from this assessment. The electronic CAT is accredited by the Department of Health.
Cambridgeshire's experience of using tablet PCs for the single assessment process collecting data for several agencies was tested as a pilot within Project Nomad. The Cambridgeshire Project Nomad primary proof of concept trial involved a computer simulation of an assessment at a client's home, using a combination of a tablet PC, mobile phone technology to call up and transfer data back into the system using mobile phone technology, employing an e-form that Cambridgeshire was already developing with European Management Systems (EMS). Serious difficulties arose during the trial that could not be resolved within the timescale and budget available, with the result that the trial had to be abandoned. See further details on the Project Nomad website.

Project Nomad - the National Project is sponsored by the Office of the Deputy Prime Minister and is dedicated to mobile and flexible working in local authorities. Cambridgeshire County Council, the original lead authority for Project Nomad, has now taken responsibility for it, providing a ‘safe home’. Current plans are to continue to promote mobile and flexible working, making use of mobile technology, via the Nomad website, through events, through partnership and collaborations with local authorities, Regional Centres of Excellence and other organisations.
Contact details:
Mark Howe, Development and Commissioning Manager - Older People, Directorate of Social Services Cambridgeshire, Castle Court, Shire Hall, Cambridgeshire CB3 0AP
Tel: +44 (0) 1223 718129 +44 (0) 1223 717834 |  Fax:  |  E–mail:  |
Other Contacts: Alan Shields
Web link(s):

Camden PCT
Camden has been working with the FACE document as a paper-based assessment which has restricted the fluidity of movement and implementation of the process.

Although the aim has been to implement FACE across Camden, into each team and service, the task has been approached in 'chunks', starting with a core team working with similar type clients ie. the District Nurses, Community care teams, SS OTs, and the Camden REACH team (re-enablement). Jane Taubman has made herself available to visit all teams and any other interested parties in their localities to facilitate distribution of the FACE documentation.

With regard to training materials Jane has used the FACE users' guidelines and was requested to design a more simple document-flow and information-sharing guidelines.

The north central sector is in very different places with regard to IT, but the general sense is that most organisations (PCTs, LAs, Acute Trusts, Mental Health Trusts) will not be going with the London SAP IT interim solution offered over the summer. Instead most areas will be developing their own local solutions, possibly based on health accessing social services IT systems and using shared SAP documentation that way - although this may change. Some professionals are already screen workers and don't want to return to paper and pen, so for them the solution at present is to use the FACE documentation on screen They can send it to each other if they are part of a system which has the appropriate safeguards, but in Camden that does not cover the Health/Social Services/Acute Trusts/ Mental Health services IT divides. Even within health there are several different systems which cannot communicate. As there is a perceived need to speed up the IT sharing of FACE across all services, we are working with our IT colleagues in health and SS to see what options can be made available asap. This looks like it might best be facilitated by all adapting to one already existing system such as the SS system being used (Corelogic in Camden). It is hoped that the GPs using EMIS will be able to transfer their core information for referral purposes initially, onto a FACE format. The GPs could then use a single referral form for all Camden services and simultaneously provide the service they are referring to with their Initial Background information.
Contact details:
Jane Taubman, REACH Link/SAP implementation, Camden REACH Team, Bloomsbury Building, St Pancras Hospital, London NW1 OPE
Tel: 020 7530 3584 Mob: 0788 799 4217 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Cardiff & Vale Unified Assessment Project,
Cardiff & Vale Unified Assessment Project includes, among others, the following partner agencies: Cardiff Council, Vale of Glamorgan Council, Cardiff Local Health Board, Vale of Glamorgan Local Health Board, and Cardiff and Vale NHS Trust. The Project has compiled a leaflet for users, "Unified assessment: helping you achieve a better quality of life" as a general guide (web link 2).
The Project is currently revising its information sharing protocol and operational agreement for unified assessment and care management system .
Contact details:
Beverley Heatman, Unified Assessment Project Manager, Cardiff & Vale Unified Assessment Project, c/o Vale of Glamorgan Local Health Board, 2 Stanwell Road, Penarth, Vale of Glamorgan CF64 3EA.
Tel: 029 2035 0663 07798 571539 (BH) |  Fax: 029 2045 0601  |  E–mail:  | 
Other Contacts:
Web link(s):

Care Planning Policy Collaborative
The Care Planning Policy Collaborative (aka the CAF Collaborative) was launched on October 2006, the aim being to support the development of a Common Assessment Framework for Adults, and guidance on Personal Health and Social Care Plans. The Collaborative will support the development of commitments made in the White Paper, "Our health, our care, our say : a new direction for community services" (Cm 6737, January 2006).
The Collaborative held its first meeting on 11 October 2006 (see Web link). The report of this first meeting brings together comments from four group sessions, and covers: content, levels of assessment, and standardisation issues;
who does the assessment - the role of GPs and carers;
developing a common workforce;
care plans - implementation systems and delivery;
and key issues still to be resolved.
Contact details:

Tel:  |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Cornwall, Devon, Plymouth and Torbay
The SAP website for Cornwall, Devon, Plymouth and Torbay councils and PCTs has a page for professionals which contains a folder of current SAP documents used within the locality - assessment tools and guidance, information sharing protocols, summary tools; SAP pack learning and development materials; SAP national documents and links. All documents can be downloaded from the site. The main SAP site includes newsletters describing progress, activities and plans for taking SAP forward in the region.

Contact details:
Heather Eardley and Jude Anthonisz, SAP Business Managers, Devon County Council, Dean Clarke House, Southernhay East , Exeter EX1 1PQ
Tel: +44 (0)1392 687142 |  Fax:  |  E–mail:  |
Other Contacts: Bruce O'Connor, SAP Project Assistant
Web link(s):

Cumbria & Lancashire Workforce & HR Directorate (formerly WDC), Cumbria & Lancashire SHA,
Celia Granell has overseen regional developments. She has worked closely with St Martins College, Carlisle to produce a work book which underpins 'Integrated Working' and contains chapters on 'Knowing me Knowing You', Shared values, Working in Teams, Partnerships, Managing and Sustaining Complex Packages of Care, Decision Making, Risk and Service Provision. Celia and her colleagues have also worked on a 'Virtual Hospital' which is populated with actual patients (all anonamised) who have a variety of diseases/traumas etc, and some of whom will undergo Single Assessment. They are hoping this will be a useful future tool for Secondary Care and Higher Education.
The SHA's Workforce Directorate employed a Single Assessment Training Co-ordinator, Rachael Rogers, on a 12-month secondment (March 2004-February 2005) to compile training materials, overarching Training Strategy and Training Plans for organisations to use or adapt to meet their needs.
Items produced by the SHA and detailed elsewhere on this website are:
"Cold Tea", a video based on primary care adapted from the Changing Workforce programme;
Leadership through change - support pack (this and the contents of the CD-ROM can be viewed via this website);
Single Assessment Process - training toolkit (the contents of the CD-ROM can be viewed via this website);
and stand alone Powerpoint training packages
The SHA also produced leaflets to inform all staff in the varying organisations, NHS, Social Services, Independent and Voluntary Sector of Single Assessment (from porters to clinicians to Chief Executives); wherever possible, these leaflets were included with pay advice slips. These can be sent on request, using the above contact. [website link ok 1/12/08 kj]
Contact details:
Celia Granell, Clinical Development Manager for Older People and Primary Care, Preston Business Centre, Watling Street Road, Fulwood, Preston PR2 8DY
Tel: +44 (0)1772 645701 (direct) +44 (0)1772 645700 (switch) |  Fax:  |  E–mail:  | 
Other Contacts: Alex Sunderland, Lancashire SSD
Web link(s):

Darlington Borough Council SSD
This authority has piloted EASY-Care but rejected it for an in-house paper assessment tool after a year's pilot scheme. This paper assessment tool will be ready for April 2004 implementation. The website gives plenty of detail about the progress made and strategy developed which involved the GOLD team (Growing Older Living in Darlington). GOLD is a ten-year strategy plan which will evolve to meet the needs of older people in Darlington. Further in-house training on SAP has been developed. Lyn Walker and Wyn Suggett are running a 6 week training programme in early 2005 in preparation for implementation in April 2005, and they can be contacted for updates re SAP.
Recent developments include:
SAP was launched across Health and Social Care on 11 April 2005. This was between Darlington PCT, Darlington SSD, Darlington Memorial Hospital via the Discharge Management Team, St Teresa's Hospice, PCT Intermediate Care Services, Macmillan Services, 24hr District Nursing Teams.
Single points of access to Intermediate Care, District Nursing Service, Social Services, Hospice/Macmillan have been achieved.
A standard referral system from all 11 GP Practices to above Single Points of Access has been implemented
. Darlington have achieved IT connectivity through community health inputting information onto the SSD Carefirst Database and have developed SAP Policy and Guidance in support of staff.
Darlington has developed a DRAFT Information Sharing Protocol and Data Flow Agreement and is developing and piloting electronic GP referral document to Community Health Services via encrypted e mail.
They have trained 175 staff on awareness and the full 2 Day Training Programme to support implementation which included: Documentation & Process Half Day and 1hr Specialist slots linked to the Tools & Scales in the Overview Assessment, covering - Mental Health, Tissue Viability, Falls, Pain Management, Medicine Management, OT/Physio, Moving & Handling, Carers & Direct Payments. All staff were requested to complete an evaluation form which provided positive feedback.
To support implementation a Staff Buddy List was developed which has proved to be highly successful.
Darlington have a multi agency Steering Group who monitor and evaluate implementation and make recommendations for future development. We are currently amending the Contact & Overview Assessment following feedback from practitioners and have circulated a Staff Evaluation Form, which will be analysed in the near future.
All Service Users are given an Evaluation Form to complete when undergoing a single assessment and Darlington have developed specific SAP Leaflets for Service Users and Staff Groups re information and consent.
They are linking to the NPfIT via our Local Service Provider and keeping up to date re current changes and have shared our information with County Durham Social Services Department and are part of the Joint SAP Steering Group across Co. Durham & Darlington.
Darlington have produced a number of documents which they are willing to share with other organisations and these are stored on the CPA SAP resource {search the resource for Darlington} [website chk ok kj 1/12/08]
Contact details:
Lesley Compson, Community Development Worker, NSF/GOLD, Darlington Social Services Department, Central House, Gladstone Street, Darlington, DL3 6JX
Tel: +44 (0)1325 346256 (LC) +44 (0)1325 346258 (LW) +44 (0)1325 746237 (WS) |  Fax:  |  E–mail:  |
Other Contacts: Lynn Walker, Social Services SAP lead; Win Suggett, Darlington PCT SAP lead (e-mail:
Web link(s):

Derbyshire and Derby County Council
Dedicated website to the single assessment process, with a map of the area covered giving details of the three electronic pilot schemes currently running in the locality. [webchk ok 2/12/08 kj]
Contact details:
Katey Twyford, Single Assessment Process Project Manager for Derbyshire and Derby Health and Social Care Community, Room G10, Social Services, County Hall, Matlock, Derbyshire DE4 3AG.
Tel: +44 (0)1629 772065 mobile: 07884495967 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Essex Single Assessment Process
The single assessment process is being led and co-ordinated across the Strategic Health Authority area and Jean Kingsley is the Project Director.
There is a pooled project budget and stakeholders to the 2-year project are:
Primary Care Trusts — Basildon; Brentwood, Billericay and Wickford; Castlepoint and Rochford; Chelmsford; Colchester; Epping Forest; Harlow; Maldon and South Chelmsford; Southend; Tendring; Thurrock; Uttlesford. Care Trust — Witham, Braintree and Halstead.
Acute NHS Trusts - Basildon and Thurrock; Essex Rivers; Mid Essex; Princess Alexandra; Southend. Mental Health NHS Trusts — North Essex Mental Health Partnership and South Essex Partnership. Councils — Essex County, Southend Borough and Thurrock Unitary.
The Essex-wide Single Assessment Steering Group (Project Team) is co-chaired by Gerry Calder, Older People’s lead for single assessment in Essex, and by Lorraine Cabel, Director of Modernisation, Essex Strategic Health Authority. The Group includes representation from Essex Housing Officers Group, and Essex Ambulance Trust, as well as all the health and social care organisations. It also includes single assessment training and IT leads from health and social care agencies each with working sub-groups.
Local implementation of the process is being led by multi-disciplinary, multi-organisational locality project teams in the five health sub-economies. The Essex Single Assessment Protocol was collaboratively developed to integrate implementation across the area and the Essex Shared Assessment Tool incorporates the suggestions of older people.
Training has been planned and delivered both in local sub-economies and Essex-wide. 800 health, social care, housing and independent sector staff together with users and carers across Essex have received initial training in locality workshops. This was jointly funded and delivered by Development Plus, Public Sector Consultants and Clara Learning. A single assessment e-learning initiative has been collaboratively developed with FAST healthcare.
Essex has an NPfIT early adopter pilot site for single assessment at Southend Acute Trust. A review of all business processes at the interface of health, social care and housing is being carried out by Swordfish (part of Lamberhurst Group) which will be used to inform the information technology requirements for implementation of the electronic solution.
The Essex shared assessment tool was collaboratively developed with special thanks to Swordfish Management Consultancy and Annie Stewart, Service Manager for Older People, Witham, Braintree and Halstead Care Trust. The tool will be used in the Single Assessment NPfIT early adopter pilot at Southend Acute NHS Trust.
A website (built by Barber Jackson Associates), will be launched during October 2004 where further up-to-date information, contact details of local implementation leads, together with information for older people will be posted.
[webchk link broken 1/12/08 kj] [SAP transformed? search yields 7 results to past documents]
Contact details:
Jean Kingsley, Essex Project Director Swift House, Hedgerows Business Park, Colchester Road, Chelmsford, Essex CM2 5PF.
Tel: +44 (0)1268 705152 (direct line) | +44 (0)1268 705000 (main switchboard) | +44 (0)1268 705101 (Pat Day - PA) | Mobile: 07786 125600 |  Fax: +44 (0)1268 705100  |  E–mail:  | 
Other Contacts:
Web link(s):

Gateshead Council, Gateshead Health NHS Trust, and Gateshead PCT
Dorothy Lumley, formerly Service Manager (Health Liaison), commented that from the outset, users and carers have been involved in the across-the-board training being undertaken in Gateshead, to focus on the person-centred care aspects, not just the form-filling. In common with other Tyne and Wear authorities, the video and other training materials developed by Brenda Stenhouse in Northumberland have been used. With no financial assistance forthcoming from other sources, that received from the Workforce Development Consortium for producing these materials is worth noting.
The weblink, "Introduction to single assessment", links to a leaflet, "Single assessment process briefing paper", which has been jointly produced by Gateshead Health NHS Trust, Gateshead PCT and Gateshead Council. The leaflet explains more about what we mean by person-centred care and how single assessment will help to achieve this.
From 1st April 2007 until further notice (and contrary to names given on the weblink) there will be no contact for SAP in Gateshead.
Contact details:
Helen Weatherly, Clinical Systems Trainer, Ward 5, Bensham Hospital, Saltwell Road, Gateshead NE8 4YL.
Tel: 0191 445 5245 (HW Bensham Hosp) 0191 443 6810 (HW, Blaydon office) |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Kensington and Chelsea PCT
Kensington and Chelsea is signed up to the North West London (NWL) sector common approach to the Single Assessment Process to enable consistency in the cross boundary exhange of care information. This includes universal forms for Basic Personal Information, Contact Assessment and Referral. FACE - Functional Analysis in Care Environments - is being used for the Overview Assessment. There is a NWL sector glossary of health and social care terms used by participating agencies.
Kensington and Chelsea with partner agencies have developed a SAP Sub-Protocol for the sharing of service user's information; a SAP Medicines Management Assessment Tool; and a Care Plan Assessment Summary and Timetable.
The NWL sector areas have obtained funding from the Workforce Development Confederation to develop joint training materials - this includes a teaching video (see separate entry). There has been some sharing out of funds across the sectors to set up delivery of local training sessions for staff. Training in Kensington and Chelsea is taking the form of:

1. Awareness training (half day for 100 staff).
2. FACE has been commissioned to do overview training, Tricia Morris (trainer). [K&C is using FACE with adaptations. ]
3. An eight-month rolling programme of seminars beginning in June to include issues around medicine management, mental health, carers, and falls.
4. Care pathways work and care co-ordination.
5. Training by experienced trainers.

Contact details:
Ruth Garry, Kensington and Chelsea PCT, Service Development, St Charles Hospital, Courtfield House, Exmoor Street, London W10 6DZ
Tel: 020 8962 4621 |  Fax: 020 8962 4607  |  E–mail:  |
Other Contacts: Tricia Morris, Independent Training and Management Consultant
Web link(s):

Kent County Council
KCC is investing in three ground-breaking electronic services to enable people to stay in their own homes and take greater responsibility for their own care.
Kent Social Services is piloting for six-months an innovative online self assessment scheme in partnership with software firm Anite Public Services. The Caring website allows people the choice to assess their own care needs or carry out an assessment on behalf of someone else by completing a questionnaire online. If a person qualifies for support, they will then be able to choose from a range of support services matching their assessed needs. In most cases, eligible applicants will be able to select a service without the need for a conventional home visit. However, a review visit will take place to ensure the arrangements are suitable. The pilot covers people with moderate needs, but the aim is to extend the service to those with critical and substantial needs. Face-to-face assessments will be retained for those who want them. The site is backed up by Kent's 24-hour call centre.
Kent Telehealth is being launched in partnership with American company Viterion. It enables patients to monitor their own health and communicate with health and social care professionals from their own home via a hi-tech user-friendly computer-based unit through a telephone line. All personal details are encrypted so there is no opportunity for hackers to access patients’ details. Although it will initially be piloted among 275 older people with chronic diseases across primary care trusts in Ashford, Maidstone Weald, South West Kent and Dartford and Gravesham and Swanley, KCC believes that the technology could eventually be used more widely. It could promote independence and self-management of, for example, care planning and be introduced into community settings such as schools, nursing and residential homes.
The Council is also using the government's direct payments scheme and plans to offer 'client cards' to allow service users to control the whole process of service selection and pay for their own care packages.
Contact details:
Kent Social Services, Kent County Council, County Hall, Maidstone, Kent ME14 1XQ
Tel: +44 (0)8458 247247 +44 (0)1622 694034 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Kirklees Council
The web link, the Single Assessment Process in Kirklees, gives a short explanation of SAP. It notes that Community Social Services Teams, District Nursing, Occupational Therapy and the Intermediate Care Service began process in January 2004, and that there is a roll-oiut programme including A&E Departments. Kirklees Older People's Network has been involved in evaluating the work with older people to make sure process meets the needs of older people living in Kirklees.
The website includes links to two action plans (listing task/activity, who and when):
North Kirklees Action Plan, Adult Services 2005, National Service Framework for Older People: Single Assessment Process: project plan, 21 April 2005.
This covers tools, assessment processes, policy, care co-ordination, CPA ( Care Programme Approach), roll-out sites, training plan, and communication plan.
South Kirklees SAP Project Group: Action plan 2005
This covers: protocols and procedures; specialist assessments and tools; Easy care; information sharing; staff information; roll out plan; mental health/CPA and SAP; care management and SAP; training plan; evaluation/audit of SAP; and carers.
Contact details:
Community Care Services, 2nd Floor, 6-8 St Peters Street, Huddersfield HD1 1DH.
Tel: 01484 226937 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Lancashire Social Services Directorate
Has established a SAP joint partnership involving 8 PCTs, 2 unitary and 2 County Councils 5 acute trusts the StHA and Workforce Development Confederation. The partnership has already produced a number of achievements including a Joint Health and Social Care Agreement and consensus on key elements of SAP. Work is being concluded on a Joint Information Sharing Protocol and a Care Management Agreement. Electronic pilots are in place at five localities across the County, they are designed to test technical IT and SAP requirements as well as operational protocols and processes for joint working. The system is an in-house development includes a care plan and automatically collects information relating to relevant Performance Indicators.
Contact details:
Mr Alex Sunderland, SAP Project Manager and Policy Officer for Older People, PO Box 162, East Cliff County Offices, Preston, Lancs, PR1 3EA
Tel: 01772 534449 (direct) 01772 254868 (switch) |  Fax:  |  E–mail:  | 
Other Contacts: Celia Granell, Clinical Development Manager for Older People & Primary Care
Web link(s):

Leeds (Leeds City Council/ Leeds West PCT / Leeds Teaching Hospital NHS Trust
Leeds was identified by DH as an early good practice locality for implementing SAP.
Dennis Holmes chairs the Leeds multi-agency implementation team, and also chairs the workforce development and training sub-group of that team. The role of the sub-group has been to bring into being the infrastructure (practical and strategic), to enable the generation of the training materials, and to co-ordinate the generation of the training materials with the work of the other sub-groups of the implementation team who are developing Leeds' overall approach to the SAP. Specifically, this has involved a considerable amount of creative fund-raising (since there are no additional resources to support implementation). Having got the first wave of training well under way, and having produced training support kits, toolkit and electronic "helpdesk" for front-line staff, the group are now looking at sustainability issues, longer term workforce development initiatives across health, social care and higher education aimed at embedding SAP philosophies in the long term.
Other key players:
Tracey Cartmell, Training Manager, Social Services (
Brian Ratner (, with Sally Mayfield, run a local e-mail enquiry service (i.e. the electronic 'helpdesk') devoted to SAP queries across Leeds.
Information from Sally Mayfield on the work being done by a sub-group on training and workforce development on a training plan/strategy, in 3 tiers:
1.Describing principles of SAP, using an awareness-raising package for use with different stakeholder organisations.
2. Equipping practitioners/assessors in EASY-Care.
3. Training trainers to deliver 1 and 2.
The Leeds Single Assessment Process toolkit (March 2004) is in the form of a guide, to give assessors the information to carry out the assessment. Training notes, OHPs and handouts are also being developed.
Contact: Sally Mayfield, Project Manager, Leeds West Primary Care Trust, Bremner House, Gelderd Business Park, John Charles Way, Leeds LS12 6QD. Tel: 0113 305 9400 (Switchboard); Fax: 0113 305 9481.
Caroline Haigh, an independent trainer/consultant has been involved in all three tiers, while Vee LeBrunn, Nurse Teacher based at Leeds General Infirmary, has also been involved with Tier 3. VLB and CH have been working together to develop this training material, for use with EASY-Care, and to reflect local issues; the first version of the Leeds Single Assessment Process toolkit (57 pp and 35 pp of appendices) was published in March 2004 (see training materials database).
In the absence of other funding for developing SAP, Leeds has been successful in generating funding from the West Yorkshire Workforce Development Confederation. In making grants, the WDC looks for projects which will be of a wider benefit to other authorities/agencies across the region. Leeds is about to receive another grant from the WYWDC, in order to take forward its work on SAP across West Yorkshire as a whole.
Contact details:
Dennis Holmes, Service Manager - Adults Leeds City Council, Social Services Department, Hunslet Hall, Disraeli Terrace, Leeds LS11 6UA.
Tel: +44 (0)113 247 8630 (SSD switchboard) +44 (0)113 247 4959 (DH) +44 (0)113 243 2799 (VLB) |  Fax:  |  E–mail:  |
Other Contacts: Vee LeBrunn, Nurse Teacher, Leeds General Infirmary; Sally Mayfield, Project Manager (LWPCT)
Web link(s):

Leeds Older People's Modernisation Team: SAP training on social isolation
As well as identifying care and clinical needs, the Single Assessment Process is intended to offer the opportunity for a holistic assessment. Social isolation and loneliness (referred to in Section 6 of the Easycare Document - the assessment tool chosen for Leeds) affects the quality of life, and the mental and physical health, of many older people - and these are needs statutory organisations are not best placed to meet.
A group in Leeds - formed largely from the voluntary sector, with Health and Social Services support - has been meeting for around two years to draw up and implement the Leeds Strategy to Reduce the Social Isolation and Loneliness of Older People. Members of this group made contact with the Leeds SAP Training and Workforce Development Group, and a training course and pack for health and social care staff was drawn up. Two half-day courses have been delivered so far as part of the Leeds SAP Mental Health training module - and have been very well received.
The course includes:
· The perspective on older people as citizens with diverse backgrounds, histories, social contexts
· Definitions of social isolation and loneliness, including reminders of the importance older people place on continuing to lead a "normal life"
· Presentation by an older person - what social isolation feels like.
· Case studies- along with a range of information and reminders about local social groups, voluntary activities, hobbies, pastimes - to stimulate thought and discussion
· A factsheet with contact details of professionals, Leeds 40 Neighbourhood Network projects for older people, and other local voluntary organisations.
The Leeds Older People's Modernisation Team produced two issues of a newsletter, The Standard, in 2004, which covered matters relating to the National Service Framework for Older People (NSF), including SAP (see weblink).
Contact details:
Bronwen Holden, Project Co-ordinator, Healthy and Active Life Standard, Strategic Services, Leeds Social Services Department, Merrion House, 110 Merrion Centre, Leeds LS2 8QB.
Tel: 0113 2478686, (BH) 0113 3059427 (KI) |  Fax:  |  E–mail:  |
Other Contacts: Kathryn Ingold, Health Promotion Co-ordinator (Older People)
Web link(s):

London Borough of Lewisham Social Services Department
Training materials have been developed which includes a video: "Patients as teachers: older people in Lewisham: good practice guide for assessment". A booklet and checklist are also included. Guidelines have been created by older people in Lewisham working with direct roots community consultants. Other partners are the Lewisham Hospital NHS Trust, Lewisham Primary Care Trust, and South London and Maudsley NHS Trust.
Contact details:
George Howard SAP Projects Manager, Social Services - 2nd floor, Town Hall Chambers, Rushey Green, Catford, SE6 4RY
Tel: +44 (0)20 8314 9608 (direct) +44 (0)20 8314 6000 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

London Older People's Service Development Programme (LOPSDP)
The Programme was a unique two-year initiative, bringing together care communities from across London to work in partnership to improve primary health and social care services for older people. Using established techniques based on the successful 'collaborative' model, the programme's goal was to promote independence and optimise care outcomes for London's older people, through the delivery of person-centred, co-ordinated services. It is a major tool in implementing the National Service Framework for Older People in London, helping to take forward its aims - particularly the single assessment process - and embed them in good practice.
The Programme ended in June 2003 but Val Jones is prepared to be a contact point for any enquiries about the Programme. There are many documents that can be downloaded from the website which contains plenty of information, newsletters, publications about the Programme. A digest summarising the Programme and the 25 projects that participated is also available.
Contact details:
Val Jones, former Director of the Programme Val Jones can be contacted at : South West London Strategic Health Authority
Tel: +44 (0)20 8545 6091 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Manchester Mental Health and Social Care NHS Trust
Malcolm Firth has developed MANCAS - the Manchester Care Assessment Schedule.
The adult (under 65) version of MANCAS is already being used in mental health trusts in Salford, Lincolnshire, Blackpool & Fylde, and Calderdale & Kirklees.
MANCAS 65 has been around for more than 3 years, and had been piloted with Manchester (undecided on SAP assessment tool). Salford Mental Health Services recently piloted MANCAS '65 against FACE, and have opted to implement MANCAS 65. MF has received enquiries from other NHS Trusts: Bury, Salford & Trafford NHS Partnership, and Morecambe Bay. He is also involved in the training for MANCAS. Also stressed that MANCAS is a qualitative tool. MANCAS was considered by the Accreditation Panel on 24/6/03, when it was commended for its conversational style, being person-centred, and covering almost all assessment domains set out in SAP guidance. On balance, the DH unable to accredit it at that time (See Web address 3).
Web address 1: CPA, Care Co-ordinator Practice Checklist. This includes outlines of: Health and Social Care Needs Assessment (MANCAS); Carer Assessment; Care Planning; Monitoring Review; Joint Working ... (with acknowledgement to Central & North West London NHS MH Trust)
Web address 2: Draft, The Manchester Care Assessment Schedule: MANCAS '65' (for use in services with older people)
Enquiries regarding the following documentation supplied by Malcom Firth should be made directly to him:
MANCAS 65 (main clinical schedule);
MANCAS 65 - brief version (reference card for discreet / community use);
Guide for training and use - older age services (single sheet for practitioners);
MANCAS 65: training version (verbal prompts in addition to evidence indicators);
Explanatory leaflet for service users, 'Assessing your needs and planning care with you';
Training notes for practitioners (© Malcolm T Firth, DEAL / University of Manchester, in association with Manchester Mental Health & Social Care NHS Trust);
Conference abstract, M T Firth Mental health professionals are not technicians: the Manchester Care Assessment Schedule (MANCAS); presented at 'Health for All: the new Agenda - Nursing and Midwifery's contribtion': Third International Conference of the Global Network of WHO Collaborating Centres for Nursing & Midwifery, Manchester, 25-28 July 2000;
Conversing with clients: a generic approach to mental health needs assessment. Article in:: Practice, vol 11, no 2, 1999, pp 35-48.
Contact details:
Malcolm Firth, Lecturer/Practitioner - Social Work, Manchester Mental Health and Social Care NHS Trust, Chorlton House, 70 Manchester Road, Chorlton-cum-Hardy, Manchester M21 9UN.
Tel: +44 (0)161 882 1000 (switchboard) +44 (0)161 882 1095 (MF) |  Fax: +44 (0)161 882 1001  |  E–mail:  | 
Other Contacts: Malcolm Firth, Hon Research Fellow, University of Manchester Department of Psychiatric Social Work: +44 (0)161 275 5220/5221
Web link(s):

NEA (National Energy Action)
NEA carries out research on fuel poverty issues and develops and promotes practical energy efficiency initiatives. Over 4 million households in the UK are living in housing that fails to meet standards for health, comfort and general well-being. It is known that the impact of cold and damp homes on both physical and mental health is a particular threat for "vulnerable" households including older people and those living with long-term conditions. Low-income, high fuel prices, poor housing, heating and insulation standards all have a bearing on the ability of householders, particularly those with long-term conditions, to maintain standards of warmth for health and comfort. It is recognised that living in cold, damp homes contributes to a massive burden of preventable illnesses, and heightens the risk of respiratory infections, premature heart disease, asthma, strokes and falls, as well as impacting on psychological health and well-being.
Though it is clearly not the responsibility of the health service to provide decent housing, there is certainly a role for health professionals, particularly those with access to those living with long-term conditions, to identify those at risk whose housing conditions may contribute to ill health, and to refer them to sources of available advice and assistance.
To this end, DEFRA (Department for Environment, Food and Rural Affairs) provided funding to engage a representative sample of health and social care agencies to provide feedback on whether they include considerations of the health impacts on those living in cold damp homes, particularly those with long term conditions, within the single assessment process and highlight current good practice, within SAP, in assessing cold related health risks.
NEA's website has a number of resources and publications linking affordable warmth and SAP, including: Prevention into action - SAP affordable warmth toolkit (March 2008) This resource is an awareness toolkit for responding to cold-related health and social care risks through the Single Assessment Process and draws on findings from NEA's 'Prevention is better than cure' research (see learning resources entry for this item). SAP provides an ideal mechanism for identifying householders at risk of, or living in fuel poverty and promoting referral into available affordable warmth services. The toolkit contains a range of presentations for local use, appropriate guidance on key issues and practical resources for frontline practitioners. The toolkit was based on findings of national scoping study undertaken in 2006/07, funded by DEFRA (Department for Environment, Food and Rural Affairs)
NEA has also completed a Briefing Note for Community Matrons, ‘Reducing the health impacts of cold damp homes on those living with long-term conditions’, which is also available at This briefing outlines a number of case studies showing ways in which Community Matrons can improve the case management and care of those living in cold, damp housing. It focuses on findings drawn from NEA’s Health Champions’ Programme and the guidance note ‘Prevention is better than cure’.
Contact details:
Diane Bland, Project Co-ordinator NEA Area Office, PO Box 113, Northallerton DL7 7AN.
Tel: 01609 883 918 (NEA Area Office) 07855 863312 (DB mobile) |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Newcastle upon Tyne City Council
Awareness raising training for single assessment started on a city wide basis in November 2002 involving users, carers and health and social care staff.
During 2003 Newcastle piloted an electronic version of the EASY-Care assessment tool using protocol software developed by Liquidlogic. The staff using this system were provided with basic IT skills training where required and training on the use of the electronic application itself. In the spring of 2004, Newcastle was approved as an Early Adopter site for single assessment development as part of the work of the National Programme for IT and its investment in Health IT systems. 21 sites were initially identified in the city for the first phase of this activity. Training needs analysis were undertaken on these staff, covering Awareness of SA, EASY-Care document awareness, basic IT skills and Electronic EASY-Care training. Between June and December 2004, Newcastle worked with partners North of Tyne. The Train the Trainers programme offered by the local service provider, Accenture, was revised by the Primary Care Trust's IT Training Lead for North of Tyne, and training was rolled out to all users for the initial phase of activity. In line with the Training Needs Analysis, staff were also offered the relevant elements of training as outlined above. Once the second phase of rollout is confirmed the above process will be repeated for all new sites.
Another important strand has been the regional training group set up by Brenda Stenhouse (Northumberland Care), which ran a conference for chief officers to raise their awareness on SAP issues. A second successful regional conference has taken place on Information Sharing and Confidentiality issues. These were supported by funds from the Workforce Development Confederation. In common with other Tyne and Wear authorities, Newcastle has been using the video and workbooks developed by Brenda Stenhouse as lead.
Brenda Rickelton now has overall responsibility for SAP. Elaine Moran, based within the Social Services Staff Development Unit, was involved with SAP on a training and awareness raising basis during 2004 and 2005 - as requested by Jeannie Fraser (former SAP lead) - but still has responsibility for SAP training as far as Performance Development goes.
Contact details:
Brenda Rickleton, Lead Care Manager Older People., Social Services Directorate, Newcastle upon Tyne City Council, Civic Centre, Newcastle upon Tyne NE1 8PA.
Tel: +44 (0)191 211 6303 (BR) +44 (0)191 277 7450 (EM) |  Fax:  |  E–mail:  |
Other Contacts: Elaine Moran, Performance Development Officer
Web link(s):

Norfolk County Council
There have been pilot sites across Norfolk. Within these sites staff have been using FACE [Functional Assessment of the Care Environment] documentation which has been accredited by the Department of Health. Many Health and Social Care settings are now involved and Districts have established Local Implementation Teams who take the lead on practice and training. There are also 2 Connecting for Health eSAP early implementation sites operating in the North and East of the County, using Liquidlogic Protocol, for the North Norfolk LHC as part of the NPfiT CRS Programme. For more information about the single assessment process as implemented by Norfolk, please download the SAP manual (version 2, April 2006) from the website link given or contact: Peter Bland, Development Officer. [website chk ok 2/12/08 kj]
Contact details:
Peter Bland County Hall Martineau Lane Norwich NR1 2SQ
Tel: 01603 495806 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

North Birmingham PCT
Birmingham Single Assessment Process Programme
Website designed as an information rich resource for all practitioners and managers involved in implementing SAP in Birmingham. Site contains all current forms used within SAP in Birmingham, including multi-agency guidelines. The aim is to put all appropriate documentation on the website, including the Birmingham SAP information sharing protocol and details on the user held record, and to encourage as much dialogue and interaction as possible with practitioners, so as to continue to develop SAP in Birmingham and to provide another avenue for support for all staff involved in this programme of change management. [webchk 1/12/08 kj]
Contact details:
Simon Fielden, Project Director, Blakelands House, 400 Aldridge Road, Perry Barr, Birmingham B44 8BH
Tel: +44 (0)121 332 1997 |  Fax: +44 (0)121 332 1901  |  E–mail:  | 
Other Contacts:
Web link(s):

North East Cluster, NHS Connecting for Health
See also: Single Assessment Process Expert Reference Group (SAP ERG) (formerly Clinical Reference Group), North East Cluster.
The North East Cluster website is a sub-section of NHS Connecting for Health, and many of the links are to that site as a whole, and not necessarily to North East Cluster items. However, it includes links to e-bulletins, for example:
NHS Update, Issue 5 [July 2006 e-bulletin] includes short piece about case studies library, noting that it will include among other things new case studies for the single assessment process (SAP).
Helen Burns is the point of contact for the Clinical Engagement e--bulletin. Issue 2, October 2006 which has an update on Expert Reference Groups (ERGs), including the Single Assessment Process Expert Reference Group (SAP ERG); and a feature on Becky Nightingale, SAP ERG Chair, in which role she wants to "continue promoting person-centred care and service delivery".
Contact details:
Helen Burns Communications Support Officer NHS Connecting for Health Prince's Exchange 2 Prince's Square Leeds LS1 4HY.
Tel: 0113 280 6368 (HB) +44 (0)609 536912 (BA) |  Fax: 0113 280 6101  |  E–mail:  |
Other Contacts: Becky Allright, SAP Project Co-ordinator, North Yorkshire Ciounty Council, chairs Single Assessment Process Expert Reference Group (SAP ERG)
Web link(s):

North East London Strategic Health Authority (NELSHA)
The North East London SAP leads have developed extensive training materials around SAP in conjunction with Eleanor Langridge of Evolutions - Professional Learning and Development (see entry on 'related organisations' listing). They have drawn on resources produced through a joint initiative by a group of project managers and trainers from the Avon, Gloucestershire and Wiltshire Strategic Health Authority. Part of the agreement for use is that the source is acknowledged and they are used in SAP multi-agency training. The original authors have given permission for trainers to adapt according to local need. The remainder of the material is original.
Training materials include a training matrix for SAP; background information on legislation and policy documents underpinning the introduction of SAP; recommended videos; SAP care coordinator role background reading on selected topics; SAP - a brief guide covering why? how? what? and key features.
Handouts consist of: a bibliography listing core reading resources; joint working - sharing values and beliefs; SAP implementation process; explaining assessment.
There are exercises around: what is assessment? assessment processes - clarifying overlap; what makes a good assessment? getting to know you - improving understanding of the older person's view of assessment; creating case studies.
SAP assessment skills - observation sheet, points to consider when watching a video; development plan.
SAP care coordinator role development plan.
Five extensive powerpoint presentations: SAP introduction; SAP principles; SAP assessment; SAP care coordinator role; SAP assessment skills.
The Essex SAP multi agency competency framework to aid single asssessment and performance management is also being used.
Contact details:
Jane Winter, Assistant Director, Social Care, Directorate of Regeneration, NELSHA, Aneurin Bevan House, 81 Commercial Road, London E1 1RD
Tel: 020 7655 6600 extn 4325 - JW 0117 900 237 - PN |  Fax: 0207 655 6675 - JW 0117 900 2465 - PN  |  E–mail:  |
Other Contacts: Paulette Nuttall, Bristol South and West Primary Care Trust
Web link(s):

North Somerset Council
North Somerset Council is using mobile technology to enable the process of assessing the needs of older people and for vulnerable adults. It has drawn on Cambridgeshire's experience of using tablet PCs for the single assessment process collecting data for several agencies at once - Project Nomad pilot. North Somerset is using two types of tablet PCs - the slate, dominated by its touch-sensitive screen, and the clamshell, which adds a keyboard and looks similar to a laptop computer, except the touch-sensitive screen can be twisted around relative to the keyboard. The Council hopes ultimately to share the data with the local NHS primary care trust through a secure weblink. One problem outside urban areas is that fast mobile data networks are often unavailable. To compensate, North Somerset's tablet PCs will upload and download data either while staff travel between interviews or when they have access to high-speed data transfer through a home broadband connection, a council office or a library.
Project Nomad - the National Project is sponsored by the Office of the Deputy Prime Minister and is dedicated to mobile and flexible working in local authorities. Cambridgeshire County Council, the original lead authority for Project Nomad, has now taken responsibility for it, providing a ‘safe home’. Current plans are to continue to promote mobile and flexible working, making use of mobile technology, via the Nomad website, through events, through partnership and collaborations with local authorities, regional centres of excellence and other organisations.
Contact details:
Mary Hammond, SAP Project Manager, Town Hall, Walliscote Grove Road, Weston-super-Mare, Somerset, BS23 1UJ
Tel: 01934 888 888 |  Fax:  |  E–mail:  | 
Other Contacts: Andy Moll, e-government strategy manager
Web link(s):

North Tyneside Single Assessment Taskforce
The awareness raising approach was used in 2004 at 8 events which were open to NHS, social care, the voluntary sector, users, carers and the independent sector. 800 invites were sent for these 2.5hrs briefing sessions, and just over 600 attended. The main focus of the events was on outcomes and person centred care. Everyone received an information pack, but at that stage, there were deliberately no copies of the assessment tools to give out. The sessions were delivered in conjunction with trainers from EasyCare.
Contact details:
Haley Hudson, Single Assessment Coordinator for North Tyneside
Tel: +44 (0)191 200 8455 |  Fax: +44 (0)191 200 8260  |  E–mail:  | 
Other Contacts:
Web link(s):

North West London Sector
A DVD and video around SAP produced by the North West London Sector in partnership with the Department of Health is now available (February 2006). Called 'Listen to what I'm saying: person-centred care and the Single Assessment Process', it is conceived as Stage 2 in a process of giving guidelines to local agencies on how to implement SAP. The aim is to give a focused examination of the process itself. Examples of good practice in how to conduct SAP are represented, featuring case studies from members of the Pullen Day Care Centre in Pimlico, and another care setting in North West London, representing a culturally diverse group of participants.
The DVD/video explains and highlights the key role of the care coordinator in providing a unified care programme that meets individual needs through liaison with appropriate services and information. The time spent on assessment and care planning saves much more time for service-providers and service-users.
Issues of widespread importance are highlighted, e.g. medication, good communication, transport, anti-discrimination and monitoring of services. Different scenarios are represented, e.g. acute and chronic care. There are two examples of journeys through individual care pathways.
It demonstrates through filmed interactions between workers and service-users the skills and knowledge that are essential to the success of the process.
In a series of research meetings with members of the care settings, good examples have been found of the key aspects of the person-centred approach to assessment.
Throughout the DVD/video it is emphasised that SAP is of benefit to care-providers as well as care-receivers, because of its practicality and its grounding in good principles of person-centred care. The DVD/video aims to be both inspirational for service-providers, and also a practical and useful training tool and reference guide.
The DVD and video are available from CPA free of charge. Supplementary documentation is available from the materials section of the CPA SAP website.
Contact details:
Keith Strahan, NHS Care Record Service - London SAP Best Practice Group Co-ordinator, London Borough of Hounslow Civic Centre, Lampton Road, Hounslow, Middlesex TW3 4DN.
Tel: 07973 700695 (mobile) 020 8583 3655 (office) |  Fax:  |  E–mail:  |
Other Contacts: Tricia Morris, Independent Training and Management Consultant
Web link(s):

Northamptonshire County Council
The Northamptonshire Overview Assessment Tool (NOAT) is fully accredited by the Department of Health as a tool for overview assessment as part of the Single Assessment Process for older people. NOAT has been developed by Northamptonshire County Council and partner agencies with the support of University College Northampton.
All the documentation has been created by local Project Groups made up of front line staff and consists of Contact Assessment, Overview Assessment, Glossary of Terms, Information Sharing Protocol and Protocol for Personal Held Records. Detailed guidelines for completing NOAT are also provided. Each client will be given a copy of their assessments to keep in a Personal Held Record. Training in how to use the new assessment forms is taking place for 2,500 members of staff from all the organisations involved and other private agencies.
The technology to share information is not yet available; all organisations have stand alone systems that do not integrate. The Health Informatics department at Highfield is currently developing a web based system which most organisations can link to until an integrated system, i.e. the electronic patient record and the NHS spine, is developed. The overview assessment will not be stored electronically although a facility for doing this will form part of the application's future development. [website link broken not found 2/12/08 kj]
Contact details:
Wendy Hoult, Project Manager Single Assessment Team, Oxford House, Floor 2, West Villa Road, Wellingborough NN8 4JR
Tel: +44 (0)1933 220 720 |  Fax: +44 (0)1933 443 929  |  E–mail:  |
Other Contacts: Liz Bell, Pilot Facilitator
Web link(s):

Nottingham City Primary Care Trust
This post is being temporarily covered by Julie Sanderson, employed by Nottingham City Council, as SAP Project Manager. Marcia Wood (Ashfield and Mansfield PCTs), has been leading on training materials for SAP in Nottinghamshire, working with a group to develop them. The above website is the main source of information about SAP in Nottingham's health services.

Contact details:
Project Manager SAP 1 Standard Court , Park Row, Nottingham NG1 6GN.
Tel: 0115 845 4545 ext 49353 |  Fax: 0115 912 3300  |  E–mail:  | 
Other Contacts:
Web link(s):

Salford Primary Care Trust/ Salford Social Services
Glyn Syson was appointed SAP Project Implementation Manager in November 2003, but although his core responsibility is now development of integrated care in Salford, there are still strong links re SAP. Some of this responsibility has now been passed to a colleague, Elainne Miller in Staff Development/Training.
At the start of the project, Glyn carried out a mapping exercise to ascertain the numbers and types of people who would be needing training: estimate of some 3,000 in Salford as a whole. He has run regular briefing sessions and producing publicity material on SAP, to engage with professionals and users. Pilot hands-on training has been done with the Intermediate Care Service (where an immediate need had been identified). A seminar for managers was run in October 2003, as a way of raising awareness on SAP.
As part of the NSF core skills training in Salford, there is one session on SAP, comprising a 15 minute Powerpoint presentation, followed by discussion. The hospital runs a preceptorship course for newly qualified staff (mainly nurses), and training around the NSF covers issues such as confidentiality, privacy and dignity, and "essence of care". Briefing sessions have been run for therapists, social workers and district nurses who are all implementing SAP in one area of Salford.
Although Glyn's core responsibility is now development of integrated care in Salford, there are still strong links re SAP, butt some of this responsibility has now been passed to a colleague, Elainne Miller in Staff Development/Training. SAP is now being implemented in Salford for all adults (not only older people) to improve assessment and care planning for all, and to keep to one process. SAP has been implemented within the Intermediate Care Service, all community older people/adult Social Work Teams, the Emergency Admissions Unit, medical and elderly care wards at Hope hospital. It also underpins practice of the Integrated Health and Social Care Team based at Walkden clinic, a new team which became operational in October 2005. There are plans to have similar integrated teams throughout the city, which will support full implementation of SAP throughout 2006, and supports requirements from the new White Paper 'Our health, our care, our say'. Formal links have also been established between SAP and the development of services for supporting people with Long Term Conditions, with Community Matrons using SAP as part of their assessment.
From an IT perspective, where possible, Salford has been working to make information available to appropriate practitioners (across organisational boundaries), and tried to develop systems to record SAP required information (most successfully within Social Services 'CareFirst' system), prior to being able to exchange information electronically between systems. The focus has been on staff development and training around implementing/adapting paper based systems to support integrated working and information sharing across traditional professional/agency boundaries. Additionally they have set the SAP Contact Assessment within GP IT systems as an electronic template, which with attached electronic reports can be used as a referral into the Intermediate Care Service.
Another project, Salford PCT's Care Call (Guardian e-public supplement, 31 May 2006) only currently supports people with diabetes. At this stage, it does not embrace wider needs and does not link with social care, but will be possible in the longer term to link developments of SAP/Common Assessment Framework, Active Case Management, Community Matrons, patient held records, Integrated Teams, etc. and being dependent on developments in IT/Connecting for Health and which IT systems are used/linked.
The SAP page on Salford City Council's website (web link 1) includes a link to a newsletter, Salford Single Assessment Process (SAP): Information and Update for Practitioners. An electronic 'Service Information Directory' called AskSID provides details about a range of services of interest for older people in Salford. Although still in the early stages of populating with information, it available for viewing (web link 2)
Contact details:
Glyn Syson, Principal Manager - Integrated Care, Community, Health and Social Care, Salford City Council, Sahal Court, 78A Great Clowes Street, Salford M7 1SR.
Tel: +44 (0)161 906 1563 or +44 (0)161 831 7484 (GS) +44 (0)161 603 4192 (EM) |  Fax: +44 (0)161 603 4205  |  E–mail:  |
Other Contacts: Elainne Miller, Staff Development Co-ordinator - Joint Trainer, Salford City Council, 8th Floor, St James House, Pendleton Way, Salford M6 5FW.
Web link(s):

Sandwell MBC
Sandwell MBC have used independent trainer, Marion Dakin, to run two training sessions - Awareness (for a wider audience and as a starting point for practitioners) and Implementation (for those conducting assessments). Marion Dakin can be contacted direct for training purposes (see separate record) and under training materials the powerpoint slides developed by Ms Dakin can be downloaded. The video mentioned "Just say it once" in the powerpoint slides is available from (see separate record under training materials).
Contact details:
Sue Howard, Older Peoples Policy Officer Rowley Regis & Tipton PCT, Kingston House, High Street, West Bromwich B70 9LD
Tel: +44 (0)212 500 1642 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Sheffield Health Informatics Programme (SHIP)
Sheffield Health Informatics Programme (SHIP) was established in April 2003 to co-ordinate local implementation of the National Programme for Information Technology (NPfIT; now Connecting for Health). The city-wide SHIP programme is being developed on a collaborative basis between the local Health Authority, NHS Trusts, PCTs and Social Services. A Professional Advisory Group (PAG) holds regular meetings to help keep people informed about proposed implementation of NPfIT; and it also holds events and workshops (about 4 a year) on topics which have included the Single Assessment Process (SAP). Information on developments can be found in the Sheffield's He@lth e-bulletin (
In May 2005, district nurses working for Sheffield West PCT were among the first to use SAP electronically (eSAP), since when district nurses across all four of Sheffield's PCTs have received training (see Web link 2); this first project also included the Evening/Night Service. Three further projects have been run: the second project was for the Intensive Home Nursing Service, while Community Matrons were included with the third and fourth projects.
A project is currently under way to deliver eSAP to the Community Assessment and Rehabilitation Teams (intermediate care) across the city; while another is under way to deliver eSAP to Heart Failure Specialist Nurses.
Contact details:
Michael Bond, Clinical Informatics Adviser Shefffield Health Informatics Service, Sheffield West PCT, 5 Old Fulwood Road, Sheffield, South Yorkshire S10 3TG.
Tel: 0114 271 1216 (MB) 0114 226 4600 (Sheffield West PCT) |  Fax:  |  E–mail:  |
Other Contacts: Sally Soady, Assistant Director (IT); Lesley Pooler, Programme Support Officer:,
Web link(s):

Shropshire County PCT and Telford & Wrekin PCT
Extensive piloting of assessment tools has taken place (FACE, CANE, EASY-Care, Rainbow) which involved practitioners and a sample group of older people. These were considered unsuitable particularly by the older people consulted. An in-house paper assessment form was developed and is now operational by both the PCTs and the Social Services. An IT based system is under review. A guidance booklet to help with completion of the assessment form for all practitioners is also being developed. [webchk link broken 1/12/08 kj]
Contact details:
Kim Baker, SAP Project Manager for Telford & Wrekin PCT, Borough of Telford & Wrekin, Darby House, Lawn Central, Telford, TF2 0DJ
Tel: +44 ( 0)1952 202820 (KB) +44 (0)1743 261300 (KJ) |  Fax:  |  E–mail:  | 
Other Contacts: Karen Jackson, Joint Commissioner for Intermediate Care (PCT & Social Care & Health), William Farr House, Mytton Oak Road, Shrewsbury, SY3 8XL
Web link(s):

Single Assessment Process Expert Reference Group (SAP ERG) (formerly Clinical Reference Group), North East Cluster
The North East Cluster's Clinical Reference Group has been renamed the Single Assessment Process Expert Reference Group (SAP ERG) to reflect participation by IT managers and business change leads.
Becky Nightingale chaired the Clinical Reference Group, and provided an 8pp briefing paper, "The North East Cluster clinical engagement". She continues to chair SAP ERG (note change of name to Becky Allright since June 2007).
View briefing paper.
Contact details:
Becky Allright, SAP Project Co-ordinator, North Yorkshire Ciounty Council Finkle Street, Thirsk, North Yorkshire YO7 1DA.
Tel: +44 (0)609 536912 07976 908812 (Mobile) |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Speakeasy (project sponsored by the Local Implementation Team for the East Lancashire National Service Framework for Older People)
Speakeasy is a pioneering project which offers peer interview training to older people, and is part of the Single Assessment Process. The aim is to train older volunteers to interview other older people about the services they receive. The feedback is used to help find out what works well and where improvements to services can be made. Burnley, Pendle and Rossendale PCT is leading the project, on behalf of other East Lancashire health organisations, and is supported by Lancashire Care NHS Trust. 30 volunteers have been trained so far: 12 through the East Lancs scheme, the rest through schemes supported by Trafford South and Southport and Formby PCTs. The Web link is Hyndburn And Ribble Valley PCT's newsletter, Primary Colour, November 2003; see page 8 for article, 'Putting older people first with Speakeasy in Lancashire!'.
Contact details:
Cath Sisson Public Involvement Manager, Burnley, Pendle & Rossendale PCT
Tel: 01282 610335 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Stockport Social Services / Stockport Primary Care Trust
Jude Wells coordinates the NW SAP officers group. Locally, quite a large piece of work has been done on developing a training strategy for SAP and other NSF standards. An older people's services training partnership has been set up that now commissions joint training across partner agencies. The training is purchased via external consultants who have developed a bespoke training programme to meet particular needs. Some introductory sessions were done in house, which were developed following a training needs analysis early in the implementation process.
Contact details:
Jude Wells, SAP Manager, Stockport PCT, Regent House, Heaton Lane, Stockport
Tel: 0161 426 5561 (JW) |  Fax:  |  E–mail:  |
Other Contacts:
Web link(s):

Tameside Metropolitan Borough Council / Tameside and Glossop Primary Care Trust
The SAP Co-ordinator has been doing training sessions for the past two years, starting with raising awareness on SAP principles. From this training, documentation has been developed. Events have ranged from sessions to get general practitioners engaged to awareness training at hospitals. This Co-ordinator has found that the peer training model has worked well and this has been particularly implemented with the PCT's district nurses.
Tameside OWL (second weblink) is aimed at service users. So too is the first weblink, a regularly updated page, which explains why the Single Assessment Process is needed, and the meaning of person-centred care. Links to items such as Department of Health guidance, the local Really Important Questions (RIQ) Group, and results of a survey, 'Tell us about your assessment' are embedded in this page. Also included is a link to newsletter published every 2-3 months, which has covered topics such as person held records, as well as reporting on progress in implementing SAP in Tameside and Glossop. [website link still live 1/12/08 kj]
Contact details:
Teresa Jankowska, SAP Co-ordinator, Tameside and Glossop Primary Care Trust, New Century House, Progress Way, Windmill Lane, Denton M34 2GP
Tel: +44 (0)161 304 5450 (TJ) +44 (0)161 304 5300 (PCT switch) |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

University of Wales Swansea, Department of Applied Social Sciences
Sherrill Evans was previously at the Social Work and Social Care Section at the Institute of Psychiatry, Kin's College London, and has worked on a range of assessment tools and instruments relating to quality of life (QOL) for people with mental health problems, also on developing a social inclusion measure,
The Lancashire Quality of Life Profile (LQOLP) was compiled in March 1990 by Dr J Oliver (who has since retired). LQOLP asks about aspects of the subject's life and overall feelings on issues covering general well-being, living situation, family relations, social relations, health, and self-conflict. The Manchester Short Assessment of Quality of Life (MANSA). Published in February 2002, this was originally developed at the Department of Psychiatry and Behavioural Sciences, University of Manchester, by Stefen Priebe, Peter Huxley, Susan Knight and Sherrill Evans. The MANSA is similar in structure to the LQOLP, and was included in a pilot of outcome measures for mental health services.
A later version, MANSA Quality of Life V2U, has been prepared by Sherrill Evans and Peter Huxley. This version uses a 7-point scale for responses each question and has been made more user friendly in consultation with mental health service users. MANSA can be used as a screening assessment, as part of an assessment process, as part of the Care Programme Approach (CPA), and as a monitoring tool or outcome measure. Its relevance to the Single Assessment Process is that it is person-centred, standardised, an outcome-centred approach that promotes quality of life.
LQOLP and MANSA are used widely in the UK and Europe. The MANSA is used in Australia, and to some extent in the USA, in research and operational practice for service evaluation. Sherrill Evans has provided the following information on the original references relating to the validation of these measures:
Priebe S, Huxley P, Knight S & Evans S (1999) Application and results of the Manchester Short Assessment of Quality of Life (MANSA). International Journal of Social Psychiatry 45:7-12
Oliver J.P.J (1991) The social care directive: development of a quality of life profile for use in community services for the mentally ill. Social Work and Social Sciences Review 3: 5-45
Oliver J.P.J, Huxley P.J, Bridges K. & Mohammed H (1996) Quality of Life and mental health services. London: Routledge.
Information on The Quality of Life in Later Life (QuiLL) Assessment can be found on the Learning materials section of this SAP training database. Enquiries regarding QuiLL, LQOLP and MANSA should be made directly to Sherrill Evans.
View MANSA (v2)*
Contact details:
Sherrill Evans, Senior Lecturer in Social Work and Social Care Department of Applied Social Sciences University of Wales Swansea Singleton Park Swansea. SA2 8PP
Tel: +44 (0)1792 602605 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

Warwickshire Health and Social Services
Warwickshire Health and Social Services has developed an in-house assessment tool and care plan which is supported by a SAP policy and procedure. It is also developing a training strategy in conjunction with Coventry University. E-learning will be key with learning advisers and a CDROM is in production; workshops with a multi-disciplinary/multi-agency focus have occurred; a video and handbook is to be produced.
A website has now been developed, which can be used as a source of information and it has all training materials on it - e.g Service user guide, Staff handbook, Guide to completing the SAP tool, the SAP tool, information sharing policy, SAP policy, guidance for particular groups of staff and information about the CD rom and video. [website chk ok kj 1/12/08]
Contact details:
Jane Blackhall, SAP Projects Manager, Bridgeway Centre, Coalpits Fields Rd, Bedworth, Warwicks, CV12 9HU
Tel: 01926 413182 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):

West Midlands Regional SAP Group (unofficial title)
Sue Williams is employed by ADSS West Midlands to facilitate service development for Old People which has increasingly led onto SAP work to develop and coordinate training resources, networks etc. A video aimed at administrative/clerical/hospital auxiliary staff is being developed by the Group. Sue Williams is keen to see the involvement of SAP web learning materials being developed by higher education establishments in the region e.g. Coventry, Staffordshire, Warwick.
Contact details:
Sue Williams, Freelance Coordinator
Tel: +44 (0)1905 796799 |  Fax:  |  E–mail:  | 
Other Contacts: Paul Jennings, Policy Lead on Older People, Birmingham and The Black Country SHA
Web link(s):

Wigan Metropolitan Borough Council
Wigan has held a small event around SAP, which Helen Coffey facilitated. A public information leaflet on Single Assessment was produced and commented on by a readers panel of older people. The SAP steering group includes two members of Wigan's Over 50s Forum.
Helen also organised hosting a performance of the Pyramid Theatre's production, 'Who's Helen?' in March 2005. Aimed at front line staff, providers and planners, the play provides an opportunity to view things from the service user's perspective. Integrated team staff, social workers, team and service managers, and ward sisters were particularly encouraged to attend.
Contact details:
Helen Coffey, Older People's Network Co-ordinator Social Services Department, Leigh Town Hall, Market Street, Leigh, Lancs.
Tel: +44 (0)1942 404501 |  Fax:  |  E–mail:  | 
Other Contacts: Philippa Easton, Pyramid Theatre Company; tel 01269 850325; Email
Web link(s):

Woking Borough Council
The twelve local authorities in Surrey have formed the Surrey-e Partnership, to work together to achieve the seamless delivery of services through the new media as they develop.
FAME is one of several programs within the Surrey-e Partnership and is funded by the ODPM. FAME (FrAmework for Multi-agency Environment working National Project) is a joint Health and Social Care project to develop a framework for information sharing in a multi-agency environment.
FAME is split into nine strands, one of which is PIVOP - promoting the independence of vulnerable older people by facilitating improved access to and communication between multi-agency services. This is to be achieved through developing and implementing a single assessment process and promoting person-centred care. Woking Borough Council is the lead with participating partners Metropolitan Borough of Wirral and Surrey County Council. Service providers have been included in the development process including four GP sites.
WBC is using FACE as the SAP assessment tool within FAME. Training is currently being developed around three elements: 1) LSP and consent issues; 2) SAP process itself - making assessments, joint working; 3) How to use the actual technology.
This project pilot offers an opportunity to make significant progress in the IT requirements of the single assessment process and to contribute to national developments in this area. Further information about FAME is available on the website or contact the FAME Programme Office at :
Contact details:
Sheila Deed, SAP Lead, Woking Borough Council, Civic Offices, Gloucester Square, Woking, Surrey GU21 6YL
Tel: 01483 755855 07808 861726 - Steve Batley mobile |  Fax:  |  E–mail:  |
Other Contacts: Steve Batley, FAME Project Director
Web link(s):

Worcestershire SSD
The website of Worcestershire County Council's Social Services has a number of electronic formatted documents (mostly pdf format) that have been developed for the single assessment process. The downloadable documents comprise consultative documents, progress reports, meeting notes, tools of assessment within a launch pack. Powerpoint presentation frames may also be available on further enquiry to Jonathan Monks . [webchk link broken kj 1/12/08]
Contact details:
Jonathan Monks, Programme Manager, County Hall, Spetchley Road, Worcester, WR5 2NP
Tel: +44 (0)1905 766963 |  Fax:  |  E–mail:  | 
Other Contacts:
Web link(s):


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