Contents
1 Introduction
These procedures cover the receipt of welfare benefits, handling of patients’ finances, purchase of goods on behalf of patients and the safekeeping of individuals personal property.
2 Purpose
The procedures are set out in this document to ensure patients’ finances and personal property is handled appropriately.
3 Scope
The principles set out in this document must be applied to all personnel who have responsibility for the handling of patients’ personal money and property. This scope is also extended to personnel who have responsibility for their welfare.
This policy covers forensic services, in-patient wards and community clients that live in their own home. Reference is made on each Section and sub-section to whom the policy refers.
4 Responsibilities, accountabilities and duties
The chief executive has overall responsibility for the maintenance and implementation of trust procedural documents.
The executive director of finance and performance is accountable for the implementation and maintenance of this procedural document.
The finance performance and information committee are responsible for the approval of this procedure.
5 Procedure and implementation
5.1 Section A Patients cash and valuables handed over for safekeeping (applies to forensic services and inpatients)
5.1.1 Section A1 on admission (applies to forensic services and inpatients)
Wherever possible patients and their relative or carer or representative should be advised on the amount and type of property, including money, to be brought into hospital and the facilities for storage and safekeeping.
They should be informed that the trust and its staff cannot accept any liability for loss or damage to personal property unless it is formally deposited with the trust and a receipt obtained.
If valuables are kept by patients a disclaimer should be completed and signed by the patient or their representative.
Patients who wish to have money credited to a patient’s money account and or valuables held in safekeeping, must hand the money and or valuables to the nursing staff on duty on the ward.
The nurse in charge will check the money and or valuables or other property in the presence of another member of the nursing staff and of the patient, if possible, and enter the amount of money and description of valuables in the ward’s patients’ valuables book. (appendix B).
The entry will be signed by the nurse in charge and witnessed by the second nurse, and by the patient if capable, or relative or carer or representative if present.
The valuables book shall be completed and witnessed for all patients who are unconscious on arrival, or who appear to nursing staff to be confused or disorientated.
It should be noted that valuables should only be entered in the patients’ valuables book if the items have physically been taken into safe custody by nursing staff. Conversely, all items taken into safe custody must be entered in the patients’ valuables book.
Care must be taken in describing valuables, for example, a watch should be described as a wristwatch or pocket watch. The type of stones in a ring should not be described, but the number must be stated, for example, ‘a ring with three stones’. Gold coloured items should be described as ‘yellow metal’, silver coloured items as ‘white metal’.
Under no circumstances should any precious stone or metal be specified when describing items in the valuables book.
The top (blue) copy of the patients’ valuables book should immediately be handed to the patient, if capable of appreciating its significance, or relative or carer or representative if present. Where the patient is incapable of appreciating its significance, and there is no relative or carer or representative, the blue copy should be retained in either the patients notes and detailed in SystmOne by ‘adding a possession’. The following should be selected where an item can be recorded and which is automatically dated or timed:
Once inputted it will then enable the item to be recorded as returned when applicable.
Any spoiled copies should be retained in the patients’ valuables book and be clearly marked ‘cancelled’.
The patients’ valuables book, together with the money and or valuables, and any relevant correspondence, must be taken to the cash office without delay.
A member of the cash office staff will check the valuables to the entry in the book, sign the second (yellow) and third (white) copies to acknowledge transfer of the property, and where appropriate, will make out a receipt for any cash. The receipt number will be written on both yellow and white copies. The receipt itself will be attached to the second (yellow) copy, which will be retained. The patients’ valuables book will then be returned to nursing staff.
At weekends, or at any time outside normal office hours, the money and, or valuables should be placed in the nearest available safe following the procedure detailed in section A3.
In the case of severely confused patients, or patients detained under the mental health act, where it appears to nursing staff that the retention of items of property by the patient is inadvisable, a decision should be taken, after consulting the appropriate medical officer, whether or not to remove the property.
5.1.2 Section A2 Patients’ property handed over for safekeeping (applies to forensic services and inpatients)
Where, in the opinion of nursing staff handling an admission, a patient does not appear to be fully capable of looking after items of property, but is unwilling to hand them over for safekeeping, they should be recorded on SystmOne (see 5.A.1 above) as part of the care plan or nursing notes.
If valuables are kept by patients a disclaimer should be completed and signed by the patient or their relative or carer or representative
Wherever appropriate, ward staff should mark such property with the patient’s name, discreetly, and without damage to the property.
Any item lost, destroyed or no longer usable should be noted in the 24 hour communication log and recorded on SystmOne via the care plan or nursing notes as soon as nursing staff become aware of the fact.
5.1.3 Section A3 Custody of patients’ monies and valuables on a temporary basis other than in the cash office (applies to forensic services and inpatients)
It is recognised that in certain circumstances it will be necessary for monies and valuables to be held elsewhere on a temporary basis.
These will be as follows:
- for cash and or valuables brought in by a patient on admission, pending being taken to the cash office when it is next open
- for retention of monies for special occasions, for example, outings, or for patients’ daily requirements at bank holidays etc
- for the monies of patients not fully capable of managing their own affairs whose condition indicates to nursing or medical staff that withdrawal of their monies on a temporary basis is in the patient’s interest
- budgeting money held on behalf of patients in rehabilitation
It should be noted that money should not be kept on wards overnight, but should be transferred to an appropriate night safe.
The following procedures will apply where wards are not provided with a lockable wall safe:
- where cash and or valuables are brought in on admission, the patients’ valuables book will be completed as detailed in section A1 of this procedure. The cash and or valuables will be placed in a sealed envelope and the signature of the depositor written clearly across the seal together with the ward name and patient name on the front. The envelope will then be taken to the central safe at the cash office, or switchboard at Tickhill Road Hospital
- a register will be kept in the safe with details as follows:
- number of entry
- date of deposit
- name of ward and patient name
- signature of depositor
- signature of recipient on deposit
- date of withdrawal
- signature of recipient on release
- signature of issuing officer
- the number of the entry in the register will be written by the recipient on deposit on the envelope before it is placed in the safe
- where appropriate on the next office working day, the cash and or valuables will be retrieved from the safe and be taken, along with the ward patients’ valuables book, to the cash office and the procedure in section A1 shall then apply
Where wards are provided with a lockable safe, this may be used for temporary custody and the following procedures will apply:
- where cash and or valuables are brought in on admission the patients’ valuables book will be completed as detailed in section A1 of this procedure
- a register will be maintained of the contents of the safe, which will detail:
- number of entry
- date of deposit
- amount of cash deposited or description of valuables as appropriate
- name of patient
- signature of receiving nurse in charge
- date of withdrawal
- amount of cash withdrawn or detail of valuables
- signature of recipient
- signature of issuing nurse in charge
The nurse in charge shall check the cash and valuables held at the start of each shift and shall complete and sign the appropriate section of the 24 hour communication card to acknowledge receipt of the contents of the safe and the key which will be kept in his or her possession at all times for the duration of the shift.
On the next office working day, the cash and valuables will be taken, along with the ward patients’ valuables book, to the cash office and the procedure in section A1 shall then apply.
5.1.3.1 Missing or damaged property and lost property (applies to forensic services and inpatients)
Any missing or damaged property will be covered by the losses and special payments policy.
Any lost property will be covered by the losses and special payments policy. This is located on the trust’s website.
5.1.4 Section A4 Discharges and transfers (applies to forensic services and inpatients)
Where the patient has deposited valuables for safekeeping, and is being discharged, the patient shall sign the personal property numbered form in the cash office to acknowledge the return of the property. Where patients are being transferred, the cash office will arrange for valuables to be transferred with the patient.
Where patients being transferred have a credit balance on their money card, this will be transferred by the finance department patients’ monies officer.
Where a patient who is to be discharged has a bank account they should be encouraged to take only sufficient funds for their immediate needs in cash and the balance by cheque. When determining what is sufficient for immediate needs, due regard must be given to the patient’s condition and financial commitments.
5.1.5 Section A5 Death of patients (applies to forensic services and inpatients)
Upon the death of a patient there are two options available for the handover of valuables to the next-of-kin:
- if the next-of-kin is present at the time of, or soon after, the death of the patient all property other than cash, may be handed over by nursing staff
- all valuables, including cash, may be taken to the cash office and handover to the next-of-kin will be carried out by the cash office staff
5.1.5.1 Handover by nursing staff (applies to forensic services and inpatients)
Upon the death of a patient all items of value, excluding cash, will be listed on an indemnity form (appendix A).
Cash must be entered in the patients’ valuables book and taken to the cash office for safe keeping, in accordance with section A1.
Payment of all monies held by the trust on behalf of deceased patients will be carried out by the finance department patients’ monies officer.
The valuables and all other property should be retained in a safe place on the ward until handed over to the next of kin.
Relative or carer or representative collecting deceased patients’ valuables must provide satisfactory identification before any items are released if they are not known personally to ward staff.
The indemnity form must be signed by the person to whom the valuables are handed and appropriately witnessed.
Where relative or carer or representative have conflicting claims no property should be handed over and the matter should be referred to the senior nurse.
5.1.5.2 Handover by cash office (applies to forensic services and inpatients)
Upon the death of a patient, all items of value, including cash, formerly in the patient’s possession on the ward will be listed in the patients’ valuables book and taken to the cash office for safe keeping in accordance with section A1. The blue copy will be retained on the ward for collection by Relative or carer or representative, in order that they may claim property from the cash office. (see 5.A.1. above regarding SystmOne).
Property other than valuables and cash should be retained in a safe place on the ward for subsequent collection by the next of kin.
Payment of monies held on behalf of deceased patients will be carried out by the finance department patients’ monies officer.
Relative or carer or representative collecting deceased patient’s valuables must provide satisfactory identification before any items are released, if they are not known personally to the ward staff.
Where relative or carer or representative have conflicting claims, no property should be handed over and the matter should be referred to the senior nurse.
An indemnity form (appendix A) must be completed for each handover of patients’ valuables. This must include all items to be handed over. This must be signed by the person to whom the valuables are handed.
5.2 Section B Patients’ income (applies to forensic services, inpatients and community clients)
5.2.1 Section B1 Welfare benefits, the effect of admission into hospital (applies to forensic services, inpatients and community clients)
Under the legislation governing the payment of welfare benefits and allowances, provision is made for the adjustment of the rate of benefit where a person is undergoing treatment free of charge as a resident patient in a hospital.
The patient is responsible for notifying the department of works and pension (DWP) of their admission into hospital, but as this requirement may sometimes be overlooked by the patient or their relative or carer or representative, the ward will notify the DWP local office of the admission of all patients.
5.2.2 Section B2 Ward staff responsibilities on admission (applies to forensic service and inpatients)
The DWP Form BR409 (appendix C) must be completed for each patient on admission to provide information on the benefits receivable by patients and who is to be responsible for their collection.
Ward staff should complete as much as possible of the form (and as a minimum, the patient’s name, home address, date of admission, and name and address of relative or carer or representative).
The completed form should be sent to the cash office who will photocopy it for internal records and send the original to the DWP.
5.2.3 Section B3 Management of patients’ welfare benefits (applies to forensic services, inpatients and community clients)
Patients will be encouraged to manage their own affairs as much as possible. Where they are capable of doing so, the trust will apply to act solely as an agent for the collection of state benefits on their behalf.
Where a patient is incapable of managing his or her own affairs and no suitable relative or carer or representative exists, the trust may seek to be nominated as an appointee to collect benefits and manage finances on the patient’s behalf.
Where the patient’s pension or allowance is being handled by a Relative or carer or representative or some other person outside the hospital, ward or support staff should monitor the situation. Where they feel that the patient is not enjoying their entitlement from welfare benefits held by relative or carer or representative, the key worker, charge nurse or sister should inform the social worker or community nurse if appropriate and, if no progress is made, the senior nurse. The senior nurse will take the matter up with the person responsible for the patient’s affairs and will ensure the matter is brought to the attention of the local office of the DWP if the situation continues.
5.2.4 Section B4 Personal allowances (applies to forensic services only)
5.2.4.1 The meaning of personal allowances (applies to forensic services only)
The expression ‘personal allowances’ covers those payments which are made to patients who are not entitled to benefit payments from the DWP. The amount paid is at pocket money rates and will be credited weekly to the patient’s accounts and then reclaimed from NHS England on a quarterly basis.
5.2.5 Section B5 Reward payments for work performed (applies to forensic services only)
A patient undertaking work as part of his or her rehabilitation may be entitled to reward payments from the trust’s revenue budget.
The eligibility for reward monies and the maximum amount to be paid shall be determined by the medical staff responsible for the patient’s care in consultation with nursing staff when the assessment of the patient’s ability to handle cash is carried out (section C).
The reward money payment should be graduated to a weekly maximum in such a way as to encourage patients to engage and persist in occupations of therapeutic value.
The maximum amount of the reward money will be determined by medical considerations, but it should be noted that if reward money (excluding any personal allowances also received by the patient) is ordinarily more than a certain sum, the patient’s entitlement to certain welfare benefits may be affected.
Similarly, national insurance contributions are payable if the amount reaches a certain greater sum. The amounts involved are subject to periodic review, and the care team should consult the senior nurse who will ascertain the current rates.
5.2.6 Section B6 Investment of patients’ income (applies to forensic services, inpatients and community clients)
5.2.6.1 Individual’s bank accounts (applies to forensic services, inpatients and community clients)
Where a patient’s bank book is taken into safe custody, it shall be handled in the same way as cash or valuables received (see section A).
If a patient builds up a significant balance of surplus funds, this may be invested in one of two ways:
- if the patient is capable of understanding the transactions involved and does not have an appointee, the individual may open an account in their own name. Such accounts will only be opened with the specific approval of the senior nurse responsible for the patient’s care and the senior nurse will notify the finance patients’ monies officer when an account is opened in this manner. The senior nurse responsible for the patients’ care will ensure that the patient is given every assistance in opening and operating the account and will be responsible for advising the patient to keep bank books and other documents relating to the account in safe custody. Arrangements should be made if requested by the patient to submit the bank book to the bank for the addition of accrued interest
- the finance patient’s monies officer will invest sums on behalf of the patient with the trust’s nominated bank
5.2.6.2 Criteria for opening an investment account (applies to forensic services, inpatients and community clients)
The investment of patients’ money outlined above will be undertaken where the patient hands over, accumulates and maintains such a balance for three months. An appropriate amount should be reserved for the patient’s immediate needs and the balance invested. In certain circumstances a lower limit than that specified or a shorter period than three months may be appropriate.
5.3 Section C Assessment of patients’ abilities to handle cash and to benefit from personal allowances (applies to forensic services, inpatients and community clients)
5.3.1 Section C1 performance of the assessment (applies to forensic services, inpatients and community clients)
For those patients for whom it is deemed appropriate, an assessment of their ability to handle cash and to benefit from any personal allowances will be carried out.
The assessment shall be undertaken regularly by the nursing staff and doctor responsible for the patient’s treatment.
The assessment shall determine the patient’s abilities to handle cash and to benefit from personal allowances, and the therapeutic desirability of his or her doing so.
The assessment shall review the arrangements for the management of the patient’s financial affairs.
The standard assessment forms (appendix D) must be used for this purpose. It should be completed in duplicate, the original to remain on the ward and the copy to be forwarded via the modern matron or senior nurse to the appropriate patients’ monies officer.
The modern matron or senior nurse, in consultation with medical staff and other members of the care team, as appropriate, will be able to authorise any temporary changes required in the amount of money that the patient may handle in cash, and shall communicate this to the appropriate patients’ monies officer.
The modern matron or senior nurse, in consultation with other members of the care team, may approve the handling of cash by group C and D patients for such occasions as outings etc.
In making the assessment, due care should be taken in accounting for all factors relating to the patient’s circumstances (for example, money from relatives, opportunity to spend the money, etc.).
5.3.2 Section C2 Definition of a patient’s financial ability (applies to forensic services, inpatients and community clients)
Four broad groups of patients can be identified in relation to financial ability. The review should determine which group is most appropriate for each patient:
- patients capable of managing all aspects of their affairs
- patients capable of making and appreciating choice, but requiring assistance in the handling of significant sums of money
- patients capable of making and appreciating choice, but not capable of handling money
- patients who are incapable of handling money or making and appreciating choice
5.3.3 Section C3 Management of patients’ finances (applies to forensic services, inpatients and community clients)
Where the trust has been nominated as appointee in respect of DWP benefits for patients unable to manage their own finances, or pays a personal allowance, every effort should be made to ensure that monies are used by, or on behalf of, the patient for the individual benefit of the patient concerned.
It should be noted that such a nomination only gives authority to spend monies on behalf of the patient arising from DWP benefits. Where a patient deposits money for safe keeping on admission, or has other income apart from DWP benefits, and such resources could be used to benefit the individual patient, application should be made to the relative or carer or representative to use such monies or, where this is not appropriate, to the court of protection for a receiver to be appointed. Until such arrangements are agreed nursing staff must ensure that balances on patients’ accounts are only spent to the extent to which they represent DWP benefits accumulated whilst the trust was appointee.
The accumulation of a large credit balance on account should not be allowed to occur except when the patient is being encouraged to save for some future purchase or event (for example, a holiday) as part of his or her therapy. However, where a patient receiving DWP benefit is fully capable of managing all aspects of his affairs and the trust is merely acting as agent for collection, no compulsion should be exerted on the patient to spend large balances accruing from such benefits. However, every effort should be made to assist the patient in his or her enjoyment of the funds at their disposal.
Where personal allowances are paid, the Senior Nurse will ensure that such allowances are received in full.
5.4 Section D cash payments to patients (applies to forensic services, inpatients and community clients)
5.4.1 Section D1 patients capable of handling their own money (group A) (applies to forensic services, inpatients and community clients)
Patients who are considered by nursing or medical staff to be capable of handling their own money (group A) shall be given the opportunity of drawing their cash individually, up to the maximum daily limit in place at that time. Larger amounts may be drawn for special purchases by prior arrangement with the appropriate senior nurse or director.
The daily request form (appendix E) held by the cash office should be completed by the patient for the amount of money to be withdrawn and then signed.
On a daily basis the request sheet is checked by the cash office patients’ monies officer to ensure that the amount requested is covered by the balance in the patient’s account.
The cash office shall then transfer all individual requests onto Patients Money Request form (appendix F), ready for that day’s withdrawals.
The patient shall sign the patients money request form to acknowledge receipt of the money. Where the patient is physically incapable of doing so, the request must be witnessed by a second member of the cash office staff. Any large amounts of cash must be witnessed by the second member of the cash office staff regardless of the patients’ capabilities.
5.4.2 Section D2 Other patients (applies to inpatients and community clients only)
Group B patients may be given the opportunity of making individual withdrawals of small sums of cash up to a small amount in any one week.
Withdrawals up to the agreed figure should be made on the daily request form (appendix E) in accordance with section D1 above.
The amount normally to be handled at any one time by a group B patient is specified in the patients’ financial assessment, see section C and this limit, subject to any temporary changes authorised by the modern matron, in consultation with medical staff, should be adhered to.
Requests for cash which are:
- from patients in group B and are above the individually assessed limit for withdrawals
- from patients who are incapable of handling money (group C and D patients); shall be made on a patients’ money request form B (appendix G)
The nurse in charge of the ward shall:
- enter on the patients’ money request form B (appendix G) triplicate form), the amount required by each patient, and complete part a) of the certification at the end of the form
- pass the form to the senior nurse or modern matron
The senior nurse or modern matron shall authorise the request form accordingly at part b).
The entire completed form shall be taken to the cash office.
The amount to be paid shall be entered by the cash office staff on the complete request form (all three copies must be attached)
The money shall be distributed by the cashier to the patient or where the patient is not available 2 members of staff (one of whom must be a qualified nurse). On ward area staff will place the money in the ward safe in accordance with section A3, pending the patient’s return.
If able, the patient will sign in the column ‘patient’s signature’. If the patient is unable to sign, an independent witness is required to sign for receipt on the patient’s behalf. To all signatures, the signature and status of a separate witness is required indicating that all payments have been made in accordance with the documented details.
It is most important if brackets are used that they span completely all payments made and the number of the lines are recorded, for example, 5 to 9.
Where any request is cancelled after completion of the form, a line should be drawn through the entry and “cancelled” written clearly across it.
The top two copies of the request form will be retained in the cash office, the third will be retained on the ward.
For normal purposes, care should be taken not to request more money in cash than the patient is capable of appreciating.
Larger sums of money may occasionally be paid in cash in respect of patients in groups B, C and D for specific, special purposes, for example, shopping trips, day trips etc. See appropriate sections.
5.4.3 Section D3 Rehabilitation patients living in the community (applies to community clients only)
For those patients who live in the community and receive cash from the cash office for housekeeping purposes, receipts will not be required from the patient.
5.4.4 Section D4 Reward payments (applies to forensic services only)
Following the assessment of rewards, a schedule of payments shall be issued by a member of the assessment team to each ward. The schedule will show a brief description of the duties to be undertaken and the amount of the weekly reward.
Reward monies will be paid out by the cash office. In some cases reward and pocket monies must be paid out at the same time, but there must be a clear distinction between the two, such that the patient can appreciate the elements of the payment they are receiving and that the combined total does not exceed the amount the patient can appreciate at any one time. In the event that any patient entitled to reward money declines to accept payment, the amount shall be credited to their account.
The weekly reward allowances to be paid in cash will be claimed by the modern matron or senior nurse in charge of the ward on the patients’ money request form B (appendix G) following the procedure outlined in section D2.
The amount claimed will vary week by week, in relation to the patient’s performance in discharging their duties, and will not exceed the maximum laid down by the medical staff responsible for the patient’s treatment in the patient’s financial assessment, see section C.
Where a patient is deemed to be a suitable candidate for reward payment, but is unable to handle cash, the modern matron will request the finance patients’ monies officer to credit the appropriate reward sum earned to the patient’s account.
5.5 Section E Purchasing goods for patients, the options available (applies to forensic services, inpatients and community clients)
5.5.1 Section E1 Introduction
The trust must obtain the best value for money possible, both in using the trust’s revenue Funds to make purchases for patients and in spending patients’ own money where the patient is not fully capable of managing his or her own affairs.
At the same time this policy must be applied sympathetically to the individual needs of the patient expressed as far as is possible by the patient.
Where patients have a limited, or no ability to handle their own affairs it is important to advise the relative or carer or representative of purchases made on behalf of patients where such relative or carer or representative make frequent visits.
5.5.2 Section E2 Methods of making purchases
Purchases may be made by patients, or by nursing staff on behalf of patients, in a number of ways. These are as follows:
- in cash or cheque by the patient, without the assistance of nursing staff, see section F (applies community clients only)
- in cash or cheque by the patient, supervised by nursing staff, at retail outlets in town, see Section F (applies inpatients and community clients only)
- with an official order raised by non-stock requisition via trust purchasing department (applies forensic services only)
- by the purchasing department on the trust’s credit card (applies forensic services only)
5.5.3 Section E3 selection of the method of purchasing (applies forensic services, inpatients and community clients)
Nursing staff must ensure that the method of supply selected is compatible with both the patient’s financial ability and the nature of the item to be purchased.
Patients’ financial ability will have been determined by the financial assessment described in section C, and will distinguish between:
- group A patients capable of managing all aspects of their affairs
- group B patients capable of making and appreciating choice, but requiring assistance in the handling of significant sums of money
- group C patients capable of making and appreciating choice, but not capable of handling money
- group D patients who are incapable of handling money or making and appreciating choice
The following sections of this procedure specify which methods of purchases are suitable for each group of patient.
5.5.4 Section E4 general principles (applies forensic services, inpatients and community clients)
Staff should exercise duty and care in handling patients’ money and transactions on their behalf. Staff should bear in mind that the various allowances which accrue to patients, either in cash or in kind, are for the exclusive benefit of the patient concerned and should not be used to benefit any other individual.
The use, by RDaSH employees, of a service users debit or credit card is not acceptable and should not be undertaken. If service users do not have the capacity to undertake financial transactions appropriate authority needs to be obtained. Advice on appointee ship and or power of attorney can be obtained from the financial accounts department.
In no circumstances must staff involve patients in mail order purchasing arrangements nor in home sales promotions or in direct selling by staff. Staff should exercise caution if approached by patients to participate in such activities.
5.6 Section F Purchases in cash from retail outlets (applies forensic services, inpatients and community clients)
5.6.1 Section F1 Unsupervised cash purchases (applies community clients only)
Patients who have been assessed as being capable of managing all aspects of their affairs will be free to spend their own money when and where they wish, and to draw it from the cash office in accordance with the procedure in section D.
5.6.2 Section F2 Supervised cash purchases (applies forensic services, inpatients and community clients)
5.6.2.1 Suitability for patients
It may be therapeutically desirable for patients in Groups B and C to visit retail outlets escorted by nursing staff in order to make purchases in cash
Group A patients who do not wish to, or are unable to make unsupervised purchases as described in section F1.1 may also make use of this method.
5.6.2.2 Purchasing procedure
The nurse in charge will complete a patients’ money request form (appendix G) in triplicate, detailing the patient’s name, the items to be purchased and the amount of cash required.
The nurse in charge will then sign the declaration at part A.
All three copies of the form should then be passed to the modern matron or senior nurse.
If approved, the senior nurse or modern matron shall authorise the request form accordingly at part B.
All three copies of the patients’ money request form B must then be taken to the cash office.
Payment will be made to the nurse supervising the shopping trip. The nurse must sign the patients’ money request forms to acknowledge receipt of the money. Under no circumstances must only one escort transport cash in excess of the amount stated in the trust’s standing financial instructions which cover this area.
One copy of the patients’ money request form will be given to the nurse for retention on the ward following the shopping trip.
Access to cash for patients on wards (under exceptional circumstances), for example, COVID-19 lockdown.
Under exceptional circumstances the trust can provide a cash loan facility to patients on wards to be able to obtain essential personal hygiene items and recreational items. This is at the discretion of the Senior nurse in charge and the financial accountant.
Receipts must be obtained for all purchases where normally available.
On returning from the shopping trip, the nurse will prepare a reconciliation form (appendix H) in duplicate and will take this, along with the original copy of the patients’ money request form B, any surplus cash and the goods purchased to the nurse in charge of the ward.
The nurse in charge will review the reconciliation form for reasonableness and will sign the reconciliation form to acknowledge receipt of the goods purchased onto the ward.
One copy of the reconciliation form will be filed together with the copy of the patients’ money request form on the ward.
One copy of the reconciliation form, the receipts obtained and any surplus cash will then be taken to the cash office. This must be done within two working days of the shopping trip.
5.7 Section G Other sources of supply (applies forensic services only)
5.7.1 Section G1 trust credit card purchases (applies forensic services only)
5.7.1.1 Purchasing procedure (applies forensic services only)
The nurse in charge will discuss with the patient what they are intending to purchase and from where. They will then authorise this request and pass the details onto the ward administrator.
The ward administrator will complete an on-line requisition detailing the goods to be purchased, the supplier, value and patients name.
The purchasing department will process this request and purchase the goods via the trust credit card.
On a monthly basis the information will be forwarded onto the finance department patients monies officer to charge the individual patients accounts for the purchases made
6 Training implications
There are no specific training needs in relation to this policy, but the following staff will need to be familiar with its contents:
- finance staff responsible of handling patients’ affairs
- nursing staff
- ward managers
As a trust policy, all staff need to be aware of the key points that the policy covers. Staff can be made aware through:
- team meetings
- team brief
- one to one meetings
- group supervision
7 Monitoring arrangements
7.1 Monitoring this procedure is being adhered to
- How: Reconciliation of nominal ledger accounts to individual patients’ accounts held.
- Who by: Central finance.
- Reported to: Head of financial planning and reporting.
- Frequency: Monthly.
7.2 Monitoring of discharges, transfers and deaths
- Who by: Central finance.
- Reported to: Financial controller.
- Frequency: Monthly.
7.3 Regular checks of valuables register to property held in safe
- Who by: Central finance.
- Reported to: Financial controller.
- Frequency: Quarterly.
7.4 Update financial assessments in conjunction with Care team
- Who by: Central finance and Care team.
- Reported to: Financial controller.
- Frequency: When required.
7.5 Ensures no breach of standing financial instructions occur
- How: Monitoring of cash requests made and monitoring requisitions going through the system.
- Who by: Central finance.
- Reported to: Head of financial planning and reporting internal audit.
- Frequency: Annually.
8 Equality impact assessment screening
Link to equality impact assessment: Patients monies and property policy EIA.
8.1 Privacy, dignity and respect
The NHS constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.
As a consequence the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity and respect, (when appropriate this should also include how same sex accommodation is provided).
8.1.1 How this will be met
No issues have been identified in relation to this policy.
8.2 Mental Capacity Act 2005
Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individuals capacity to participate in the decision making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.
Therefore, the trust is required to make sure that all staff working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005) to ensure that the rights of individual are protected and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.
8.2.1 How this will be met
All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act (2005). (section 1) Staff appointed as appointee will look after the financial interests of individuals who are unable to do this themselves.
9 Links to any associated documents
10 Appendices
10.1 Appendix A Identity form
10.2 Appendix B Patients valuable book
10.3 Appendix C Notice of admission to hospital
10.4 Appendix D Assessment form
10.5 Appendix E Daily money request form
10.6 Appendix F Patients money request form
10.7 Appendix G Patients money request form B
10.9 Appendix H Reconciliation form
Document control
- Version: 5.2.
- Unique reference number: 202.
- Approved by: Corporate policy approval group.
- Date approved: 7 November 2023.
- Name of originator or author: Deputy director of finance.
- Name of responsible individual: Director of finance and performance.
- Date issued: 7 November 2023.
- Review date: 31 May 2024.
- Target audience: Managers, nursing, support and administration staff involved in assisting patients with their personal finances.
- Description of changes: Review extension to May 2024.
Page last reviewed: April 10, 2024
Next review due: April 10, 2025