Decision details

Reason for the decision:

It is the ambition of KCC for the people in Kent to have home-based care and support services, in line with Home First principles. Discharge Pathway 1 Services enable the Council to deliver towards this ambition. The pathway relates to people being discharged from hospital with home-based support; all people needing such support should be offered reablement and rehabilitation and, where necessary, time for assessment and future care planning. This includes people whose package of care is being restarted after lapsing during their hospital stay.

The Discharge to Assess Service Contract was commissioned by Kent County Council (KCC) and forms part of Discharge Pathway 1 Service, for people discharged from hospital who need support to recover at home. Across Kent, there are a few other services that also align with the pathway, commissioned by the Integrated Care Board (ICB) and other health partners.

Discussions between KCC and the ICB resulted in in principle agreement to a new model, but more time is needed to undertake appropriate governance and subsequent implementation. 

Options (other options considered but discarded)

Do nothing – if the contract terminates this would impact on people who require support at home in the early days post discharge, the Discharge to Assess activity would transfer to higher costs services and the gap in service provision would impact on delayed hospital discharges.

Financial Implications

This is a demand-led service and activity can fluctuate. The annual budget for the Discharge to Assess is £2,953,400 with additional budget of £732,600 for bridging.  The service’s forecast spend this year is £3,928,400; an overspend of £242,400. 

If the contract is extended by nine months, it is anticipated that costs of the extension will be circa £2,970,000 (based on current activity) and within the budget for the service.

Historically, the ICB has financed additional Discharge to Assess capacities (for example from NHSE winter funding); the ability to incorporate additional funding, including from the ICB, over and above the KCC budget allocation will still be available within the extension period.

As Leader of the Council, I agree to:

a)    APPROVE the Direct Award the Discharge to Assess Service Contract to the incumbent provider (Hilton Nursing Partners) for up to nine months from 1 January 2024 to 30 September 2024 and

b)    DELEGATE authority to the Corporate Director Adult Social Care and Health to take other relevant actions, including but not limited to finalising the terms of and entering into required contracts or other legal agreements, as necessary to implement the decision.