Agenda item

The Director of Health and Wellbeing reported on the progress made on the recommendations from the joint Health and Improving Lives Select Commissions’ review into Continuing Health Care (CHC).

A senior management group consisting of both RMBC and NHSR staff had agreed a set of actions to ensure effective multi-disciplinary working and delivery of better outcomes for customers:-

-          CHC and Social Care Assessments - An improved working relationship now existed and an understanding of each professional’s role in participating in a multi-disciplinary assessment and completing the Decision Support Tool.  However, it had yet to be seen whether this would impact upon the financial position as positively as was required.

-          Assessment, Decision Making and Access to CHC for Children with Complex Needs - For children and young people with significant needs, there were 2 main areas which needed to be improved.  Firstly, reviews of current cases and consideration of a number of new cases which had yet to be assessed and considered by the Panel and secondly, an improved system of decision making through a revised Continuing Care Panel which complied with national guidance on Children’s Continuing Healthcare and ‘Who Pays’.  There had been a commitment to address the backlog by the end of March, 2014, however, it had since become apparent that the Clinical Commissioning Group (CCG) and Commissioning Support Unit (CSU) were unable to meet the deadline and it is now likely to be June.  It had since been agreed that the CCG would backdate their financial commitment for cases in 2013/14 to the date from which the package of care started for children and young people agreed as eligible for CHC funding and they were seeking clinical assessment support to carry out the work.  CCG and Council staff were meeting fortnightly to progress the agreed programme of work.

-          Joint Protocol – Had been drafted and work had commenced with Continuing Health Care manager/staff and RMBC CHC Champions – CHC Lead now in post. Specific training for those working in Children’s Services would be based upon regional advice following the National Guidance on CHC and take account of the new Panel arrangements.  The Protocol would include how to resolve disputes and written guidance for staff produced to ensure consistency and compliance once issued.

-          Training –  To be delivered jointly by CHC/RMBC leads and rolled out across hospital, Community Health and Social Care Teams.  Progress on delivery had been delayed as CCG required to provide information regarding the start date.

It was noted, that since the report had been produced, the training had been stopped and that the CSU had taken the decision to provide training on a regional basis.  This was disappointing given the agreement made and also raised concerns about consistency if people were no longer training with their local colleagues.

The RMBC/CHC Senior Management Group, Personalisation Stream, would continue to meet and consider budget issues/develop cost effective delivery of personal health budgets by 1^st April, 2014, based on a pilot project implemented from 1^st April, 2013.

The latest Yorkshire and Humberside CHC benchmarking information for the final quarter ending 31^st March, 2013, revealed that Rotherham was marked 7 out of 15 in terms of the number of people receiving CHC funding.  In terms of actual expenditure Rotherham was ranked 10^th and, therefore, still below the average spend per person within the region.

It was noted that Healthwatch Rotherham had approached the CCG and CSU regarding concerns expressed by members of the public regarding the lack of information available and the commissioning of reviews.  This was echoed across the region.

The CCG held the CHC budget and had commissioned the CSU to carry out assessments and manage the budget, but the performance management arrangements and outcome measures were unclear.

Resolved:-  (1)  That the update on progress and issues arising from the Scrutiny Review of Continuing Healthcare be noted.

(2)  That due to the concerns expressed, the Clinical Commissioning group be requested to attend a future meeting.