To receive a verbal progress report from the Strategic Director Adult Social Care on progress with the proposed new policy.
Minutes:
The Commission received a verbal update from the Director of Operations and Corporate Affairs, Leicester City Clinical Commissioning Group on the current situation in relation to the Settings of Care Policy. It was intended to submit a report to the December meeting of the Commission.
The Settings of Car Policy which provides individual support care and provides guidance on the funding for care in that setting was first drafted in 2011. A review of the policy had been led by East Leicestershire CCG and the final draft on the review had been considered by the Leicester City CCG in July. The City CCG had decided not to adopt the revised policy at this time as it had felt that further work was required in relation to the impact assessment of the change upon the poorest and poorliest section of community receiving the care. This was because of the proposed reduction from a 25% cap to a 10% cap.
The CCG had asked for further impact studies to be undertaken over the next 3 months. The impact upon new patients would be reviewed as if new policy was in place to see the impact it would have. These reviews would end in November and the CCG would consider the issue again by January 2018. The existing 2011 policy would remain in force for the City and West Leicestershire CCGs until the issue was considered again following the current review. Although the East Leicestershire CCG had approved the policy they had not yet decided when it would be implemented. The City CCG had taken this action because it affected patients with a severe disability such as a brain injury. Patients could live for a long time and require significant support for their care either at home or in a setting of their choice. There was a risk with the proposed changes that some vulnerable patients could be moved out of a home setting and put in an institutional setting, which could impact significantly upon both the patient and their family.
The Deputy City Mayor welcomed the CCG’s decision not to proceed at this time. He had concerns that there was risk of post code lottery in relation to Care Policy within the 3 CCGs for LLR. He felt this was part of an issue around the sustainability of the working arrangements for the 3 CCGs and the need for coherence within the system.
Members commented that:-
a) This showed the fragmentation within the current system and it was questioned how the STP could be applied across the LLR footprint if there was going to be differential implementation of the policy within the geographical area of the STP.
b) The continuance of 3 separate CCGs was questioned as the current situation could lead to differential standards of patient care within the STP.
c) It was also considered that health inequalities would be amplified by the 3 CCGs working differently in affluent areas to those with high levels of deprivation
The Chair commented that there would be an opportunity to look at the issue in more detail in November. The Chair commented that the Council had already received letters asking this issue to be considered.