The Cabinet Member for Adult Social Care and Health is asked to:
i. APPROVE the revised model for the Community Equipment Service and the arrangements to secure the appropriate contract for a period of five years from 1 April 2024 to 31 March 2029, with the option for a contract extension of a further two years from 1 April 2029 to 31 March 2031;
ii. DELEGATE authority to the Corporate Director Adult Social Care and Health, to finalise terms of and award contracts to the successful provider and to approve, in consultation with the Cabinet Member for Adult Social Care and Public Health and the Corporate Director Finance, the exercise of any extensions permitted within the agreed contacts; and
iii. DELEGATE authority to the Corporate Director Adult Social Care and Health to take other relevant actions, including but not limited to entering into contracts and other legal agreements, as required to implement the decision.
Reason for the Decision:
The current Integrated Community Equipment Service is jointly funded by Kent County Council (KCC) and the NHS Kent and Medway Integrated Care Board. The contract covers the purchase, delivery and repairs/servicing of equipment into people’s homes. The service enables people to live more independently for longer and supports timely discharge from hospital.
All items of equipment are loaned to people and when no longer needed are collected. Where possible items are recycled and reused. A range of credits are received by KCC, on some items of reused equipment.
Following the decision to devise and procure a new service model for the provision of community equipment (Decision 22/0081), the council has led programme of procurement activities to prepare for the commissioning of a new service. Extensive engagement and co-design work has taken place with people who draw on care and support, including those with lived experience; prescribers of such equipment in health and social care professions and the market. This has informed the design of a new model for a Community Equipment Service.
The new service model will align to the priorities of ‘‘Framing Kent’s Future – Our Council Strategy 2022 – 2026’ and will: -
The preferred model remains a loan and recycle model but has the following additional benefits:
· An enhanced (85%) credit model with increased recycling linked with Waste Management Services.
· Digital signposting to support people who wish to self-purchase.
· A partnership approach to support adaptability, innovation and collaboration.
· A greater choice in delivery and collection times.
· Improved equity of service access.
· Improved financial and environmental sustainability through greater recycling/reuse of equipment, increased credit model and options to self-purchase.
The specification for the new model has no reduction in service or eligibility.
Other options considered but rejected are as follows:-
Reason for Rejection
A Purchase model with no recycling
Environmental impact, instability of costs and missed opportunity to achieve deliver savings.
A Hub and Spoke model
Increased clinical risk to people, poor access for people who draw on care and support. Additional costs.
A reduced catalogue of equipment
Increased clinical risk to people, poor alignment with statutory duties and risk of delayed discharge from hospital.
A block contract model within reduced financial envelope
Poor value for money and risk to service quality. Reduced innovation and adaptability.
The council is using the nationally available and PCR (2015) compliant Kent Commercial Services Framework. Four of the largest providers of community equipment are on the Framework. The opportunity to bid for the new service will be published in August 2023. The contract will be awarded in October 2023, allowing for a five-month mobilisation period in order that the new service is operational by 1 April 2024.
Decision type: Key
Reason Key: Affects more than two Electoral Divisions;
Decision status: For Determination
Division affected: (All Division);
Notice of proposed decision first published: 01/09/2023
Decision due: Not before 30th Sep 2023 by Cabinet Member for Adult Social Care and Public Health
Reason: To allow the required 28 day notice period under Executive Decision arrangements
Lead member: Cabinet Member for Adult Social Care and Public Health
Lead director: Richard Smith
Department: Social Care, Health & Wellbeing
Contact: Simon Mitchell, Senior Commissioner 03000 417156 Email: email@example.com.
Cabinet Committee recommendations and other consultation:
The proposed decision was discussed at the Adult Social Care Cabinet Committee on 13 September 2023 and the recommendations were endorsed.
The proposed decision will be discussed at the Adult Social Care Cabinet Committee on 13 September 2023.
Financial implications: This is a demand-led service and activity can fluctuate. The total value for the length of the five-year contract term will be up to £82.5m, increasing to £115.5m if the two-year extension option is implemented. Financial modelling shows that should all targets on recycling and self-purchase be achieved, the contract could make savings of circa £7m over its initial five-year term, when compared to forecast costs of the current model over the same timeframe. Savings could continue to be made over any extension period applied.
Legal implications: The provision of services to support people with health and/or social care needs following discharge from 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". The option of self-purchase is therefore a choice to enable people, who wish to self-purchase, to choose the right equipment safely. Independent Legal advice has been sought regarding Terms and Conditions of the Framework to mitigate any procurement risks.
Equalities implications: An Equalities Impact Assessment (EQIA) was completed in January 2023 and revised in July 2023 following the initial co-design engagement events which highlighted a gap in representation from people who are not White or English speaking. Additional targeted engagement events were held and learning was used to revise the EQIA and inform the specification and all other tender documents. Data Protection Implications: A Data Protection Impact Assessment has been completed. Prospective providers have all been subjected to robust testing of their information security management policies and processes and the technical security and design of their systems in order to be added to the Framework and were found to be compliant.