Agenda item

The Director of Communications at NHS Leicester City presents a report on NHS Leicester City’s tendering process to increase community based beds in the City.

Jo Yeaman, (Project Director working for Primary Care Trusts in Leicester, Leicestershire and Rutland), presented a report on NHS Leicester City’s tendering process to increase community based beds in the City.  The Committee noted that this report had been approved at the NHS Leicester City and NHS Leicestershire County and Rutland Board Meeting on 10 March 2011.

Jo Yeaman explained that, typically, patients needing intermediate care beds were over 65, but this was not a requirement.  There were three types of intermediate care beds, so patients went in to them with a very clear care plan:-

·            To avoid admission to hospital:  These tended to be used by elderly, frail patients who were experiencing some kind of crisis, but which was not acute enough to lead to them being admitted to hospital, (for example, when help was needed in managing a condition);

·            For patients who had been in hospital:  These were used by patients who were medically fit, but needed more care before they went home; and

·            Rehabilitation:  These were the most used type of intermediate care beds.  Patients were able to learn new skills that enabled them to look after themselves at home.

It was acknowledged that there could be better outcomes for patients if there was better access to intermediate care, so a target of having 57 intermediate care beds had been set.  There currently were 27 in the City, which were spot-purchased, (ie, as needed), from Brookside (for hospital avoidance) or Clarendon Mews (for rehabilitation).  The 18 beds in the County were located across various hospitals.

It was proposed to increase the number in the City by 12.  It had been suggested that Leicester General Hospital would be the most appropriate place to have these beds, but the accommodation there was not right to enable patients to be rehabilitated effectively.  This option had not been rejected, but had been put on hold.  Different types of staff were needed for the different types of intermediate care beds, so if all of the beds were in one unit the staff could be deployed where they were needed.

An advertisement would be released on 30 March 2011, inviting expressions of interest.  It was hoped that the new arrangements could be in place in time to deal with the increased pressures experienced over winter periods, to ensure there was no service disruption.  Some suppliers could need a longer time to prepare beds, (for example, if they were a new supplier), but until options had been identified, it would not be possible to do a risk assessment.  Jo Yeaman offered to bring this assessment to the Committee when it was complete.

The following points were made in response to questions from Members:-

·            People typically stayed in an intermediate care bed for a maximum of between four and six weeks.  However, in the City a lot of beds were for rehabilitation purposes, from which people moved on in approximately two weeks;

·            The provision of additional beds would reduce delays currently experienced by people needing an intermediate care bed.  Achieving this reduction was a performance indicator and a key reason for increasing provision;

·            Different suppliers made different charges for their beds, which accounted for the differences in costs between the City and the County.  There also were differences in accommodation and staffing costs, due to the different needs of the users of the different types of bed.  It was hoped that the new contract would make the provision of beds more cost-effective;

·            The modelling used to assess the need for beds had taken in to account expected long-term population growth; and

·            NHS Leicester City was working with Leicestershire County Council to develop a joint strategy for intermediate care, as it was very important that the work being done was more co-ordinated.  It was expected that the strategy would be available in May 2011 and Jo Yeaman offered to report it to this Committee when it was available.