Agenda item

To consider a report from the Leicester City Clinical Commissioning Group (LCCCG) that provides an update following developments in relation to Continuing Healthcare (CHC) and the process for agreeing jointly funded packages of care between the LCCCG and Leicester City Council.  

Chris West the Director of Quality and Nursing, Leicester City Clinical Commissioning Group (CCG) and Fay Bayliss, Deputy Director of Quality and Nursing, Leicester City CCG presented a report that provided an update following developments in relation to Continuing Healthcare (CHC) and the process for agreeing jointly funded packages of care between the Leicester City CCG and Leicester City Council. Members heard that in February 2018, the Equity and Choice Policy was ratified. This policy superseded the former Settings of Care Policy and emphasised the promotion of independence and choice for patients

Members considered the report and the Chair commented that about two years ago, the Scrutiny Commission had very much welcomed the retention of the Settings of Care threshold of 25%.

In response to a question, Members heard that an individual who had demonstrated a primary health care need might opt for a Personal Health Budget. These budgets gave people with long term health conditions and disabilities more choice and control over the money spent on meeting their health and wellbeing needs. This budget was different to a Personal Independent Payment (PIP) which was assessed and managed by the Department of Work and Pensions.

The Strategic Director of Social Care and Education commented that the joint funding arrangements between the local authority and the CCG had resulted in an additional cost to the council because they were funding proportions of care packages that they had not had to do before. The Strategic Director added however, that it was the right thing to do in that he consistently promoted that access to CHC was an individual right and not an intra-agency funding issue, and that the improvements in processes and administration that had come in the local CHC arrangements from the new provider commissioned by the CCGs were very welcome.  The Chair added that it was a good example of where Social Care and the NHS were working well together.  Micheal Smith, Manager for Health Watch Leicester and Leicestershire commented that CHC was a worry for many people and the implementation of the Equity and Choice Policy was an example where patients’ concerns were being listened to.

A Member expressed concerns that the system would not work for everyone. She referred to issues around Delayed Transfers of Care where patients and families might not agree on the best way forward. The Director of Quality and Nursing explained that that were advocate services to help. The Deputy Director added that positive collaborative work had taken place with Adult Social Care on the Discharge to Assess pathway, operating on the Home First principle. Members heard that the Equity and Choice Policy was driven by patient experience and the Health Watch Manager added that the work undertaken in Community Service Re-Design would help in the process.

The Strategic Director of Social Care and Education said that the default position was that Adult Social Care would not by default ‘step in’ and fund where a decision about CHC was pending. Furthermore, the Strategic Director also highlighted that access to CHC not only released funding but also ensured access to a support network for the individual in terms of meeting their care and support needs around CHC funding of their care package.

The Chair drew the discussion to a close commenting that the report was encouraging.

AGREED:

                   that the report be noted.