Proposed decision:
Extend the Discharge Services contracts until 31 March 2022 at a cost of £1,659k, with a further option to extend until 30 September 2022; extend the east Kent Cottage Hospital discharge service until 31 March 2022 at a cost of £914k, once the NHS funding position is confirmed and delegate 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 required contract or other legal agreements, as necessary to implement the decision.
Further information:
The current hospital discharge service contracts encompass Discharge to Assess and Assisted Discharge, which form part of Pathway 1, for people discharged from hospital who need support to recover at home. The contracts were due to expire on 31 March 2020 and were extended to meet the unprecedented Covid-19 pandemic.
The Council was in the process of undertaking a procurement exercise, with new contracts due to go live in April 2020. Due to the unforeseeable circumstances the Council was unable to award contracts within the planned timescales. The existing contracts were therefore extended in accordance with PCR 2015 - Regulation 32(2)(c) and Procurement Policy Note 01/20.
Dealing with the pandemic enabled us to work more closely with our health partners and highlighted potential to significantly improve the hospital discharge pathways. RETHINK Partners were commissioned to undertake a review of the adult social care discharge pathways, co-sponsored with the NHS.
The learning from this review, will provide the foundation of the specification for a new Pathway One Discharge Service to commence in April 2022.
Enabling the extension to the current services will ensure that service delivery is not disrupted by mobilising new contracting arrangements over winter. Due to the interdependencies involved, it is prudent to request that an additional six-month optional extension until September 2022 also be agreed.
Some of the recommended improvements can be implemented into the existing contracts and will immediately help to address current issues in the market which have a detrimental impact on the flow of people through the system back to their own home.
Reason for the decision: This decision to extend contracts is required to allow for the continuation of Discharge Services until recommissioning can be concluded.
Decision type: Key
Decision status: Recommendations Approved
Notice of proposed decision first published: 15/06/2021
Decision due: Not before 14th Jul 2021 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
Contact: Roxanne Jefferies, Business Change Manager Tel: 03000 418087 Email: roxanne.jefferies@kent.gov.uk Tel: 7000 3511.
Financial implications: The cost to extend the substantive Discharge to Assess and Assisted Discharge contracts for an additional six months is £1,695k; costs for these contracts currently come from the Section 75 pooled budget. The cost to extend the remaining element of these services is £914k
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.
Equalities implications: An EQIA has not been completed. The variation agreement was centred on enabling quick and safe discharge and more generally reducing pressure on acute services, and the recommended extensions continue to support that. An EQIA was completed for the commissioning of the Care and Support in the Home service