Extension of the current Discharge Pathway 1 Services contracts (Discharge to Assess Service and Assisted Discharge Service) for one year, from 1 October 2022 to 30 September 2023; commencement of activity to develop a long term jointly commissioned Discharge Pathway 1 Services model and delegation of authority to the Corporate Director Adult Social Care and Health to take relevant actions, including but not limited to finalising the terms of and entering into legal agreements, as necessary to extend the current Discharge Pathway 1 Services; and to facilitate activity with regard to developing the jointly commissioned Discharge Pathway 1 Services model, with NHS Partners.
Reason for the decision:
The current hospital discharge service contracts commissioned by Kent County Council encompass Discharge to Assess Service and Assisted Discharge Service, which form part of Discharge Pathway 1 Service, for people discharged from hospital who need support to recover at home. Across Kent, there are a number of other services that also align with the pathway, commissioned by the Kent and Medway Clinical Commissioning Group (KMCCG) and other health partners.
The contracts were originally due to expire on 31 March 2020 but were extended to 30 September 2022, due to the unprecedented demands of the Covid-19 pandemic and the need to ensure that service delivery was not disrupted.
These services are essential in ensuring that people are able to recover at home following discharge from hospital and be supported until further assessment can be undertaken if required, alleviating blockages in patient flow through the system and preventing unnecessary delayed discharges; as such, it is essential that any new model of service delivery adequately supports both the process and the person, with capacity in the right place, at the right time.
To avoid any gap in service delivery, new arrangements must be in place by 1 October 2022.
The annual budgets for the Discharge Pathway 1 Services are set out in the table below:
Opportunities to improve the current service model, incorporating the Making a Difference Everyday (MADE) design principles of ensuring people have the right support, in the right place, at the right time as well as generating efficiencies which will be explored as part of the jointly commissioned long-term approach. Historically, the Kent and Medway Clinical Commissioning Group has financed additional Discharge to Assess capacities; the ability to incorporate additional funding will still be available within the extension period.
Decision type: Key
Reason Key: Expenditure or savings of more than £1m;
Decision status: Recommendations Approved
Division affected: (All Division);
Notice of proposed decision first published: 22/06/2022
Decision due: Not before 21st Jul 2022 by Cabinet Member for Adult Social Care and Public Health
Lead member: Cabinet Member for Adult Social Care and Public Health
Lead director: Richard Smith
Department: Social Care, Health & Wellbeing
Contact: Sharon Dene, Senior Commissioning Manager Email: firstname.lastname@example.org.
The proposed decision was discussed at the Adult Social Care Cabinet Committee meeting on 13 July 2022 and the recommendations were endorsed.
Financial implications: As above.
Legal implications: The provision of services to support people with health and/or social care needs following admission to hospital is detailed within the Care Act 2014. Paragraph 8.14 of the Statutory Care and Support Guidance states that local authorities may not charge for assessments, community equipment and minor adaptations, intermediate care or reablement for up to six weeks. Regulation 72(1)(c) of the Public Contracts Regulations 2015 allows for modification of up to 50% of the original contract value where the need is brought about by circumstances that a reasonable authority could not have foreseen.
Equalities implications: An Equalities Impact Assessment (EQIA) was completed for the commissioning of Care and Support in the Home, including these services. An EQIA for this decision has not been completed, as there is no change. The previous variation agreement and extensions were centred on enabling quick and safe discharge and more generally reducing pressure on acute services, and these recommended extensions continue to support that. An EQIA is being undertaken to support the long-term jointly commissioned option. There are no anticipated data implications associated with this decision, as there will be no change to current services, or the data collected or shared, and therefore this will be covered under existing contract clauses. A Data Impact Assessment will be undertaken to support the long-term jointly commissioned option.