Agenda item

Report of the Strategic Director of Adult Care and Housing

Cabinet Member:     Councillor Roche

Commissioner:         Ney (in advisory role)

Recommendations:

1.    That the Clinical Commissioning Group be designated as Lead Commissioner for the Community Occupational Therapy Service.

2.    That the proposal to extend the contract for the Community Occupational Therapy Service for a period of up to 12 months from the 1 April 2017, for the reasons identified in Section 3 of this document, be noted.   

Consideration was given to the report which confirmed the Community Occupational Therapy (COT) service was a jointly commissioned service between the Council and the Rotherham Clinical Commissioning Group (CCG), via a pooled budget arrangement under a Section 75 agreement covering the Better Care Fund (BCF).

The COT Service was currently delivered under a block contract agreement by The Rotherham Foundation Trust (TRFT) and the current contract would expire on 31^st March, 2017.

The service provided assessments for adults, older people and children who were permanently or substantially disabled and their carers. The overall cost of COT services in 2016/17 was £746,000 per annum, with the Council contributing £372,000 towards the service and the CCG contributing £374,000 per annum. The Council was the lead commissioner for this service and was accountable to the Health and Wellbeing Board and the Better Care Fund Executive Group.

A formal review had recently been completed by the Council and CCG in order to:-

(a)   Ensure that the service was meeting the needs of customers and their carers.

(b)   Reduce the waiting times for assessment.

(c)    Reduce the number of customers being referred to the service by signposting them to alternative services at the first point of contact.

(d)   Carry out analysis of performance data to predict demand and capacity of service.

(e)   Carry out analysis and evaluation of customer and carer satisfaction rates and outcomes.

(f)     Examine whether the service promotes Value for Money.

The review demonstrated that the COT service was carrying out assessments for low level/single need customers and that resources needed to be diverted towards providing assessments to support complex needs (e.g. moving and handling techniques to support carers, prescribing major adaptations). In addition to this, it was identified that Assistant Practitioners/OT Assessment Officers (formerly known as Technical Officers/Social Services Officers) could be upskilled to carry out assessments for level access showers, straight stair-lifts and ramps and that the level of paperwork completed was onerous and needed to be streamlined.

It was, therefore, recommended that the contract for the Community Occupational Therapy Service be extended for one further year to allow alignment with the Adult Care Development Programme (including the BCF Work Programme) and the evolving Specialist Housing Strategy. Within the extended period to April 2018, providers would be expected to achieve all recommendations highlighted in the COT review report and to work with the Council and the CCG to implement new models of service delivery.

The Lead Commissioner arrangements for the Community Occupational Therapy Service were proposed to be assigned to the Clinical Commissioning Group (CCG) as they have the largest financial stake and greater capacity to lead this activity.  The Better Care Fund Section 75 agreement with Rotherham CCG allowed for the assignment of the Lead Commissioner responsibilities, which had been approved by the Better Care Fund Executive Group.

Extension of the current contracts for a period of up to 12 months would ensure that services could be redesigned, would allow time for the purpose and nature of future preventative services to be agreed in line with the Council’s and CCG’s Transformation programmes, Corporate Plan, Health and Wellbeing Strategy and the Better Care Fund Plan 2017/19. It would also ensure appropriate commissioning actions were taken to streamline services and ensure funding streams were appropriately placed prior to commencing a competitive tender process.

It was noted that the Overview and Scrutiny Management Board had made the following recommendations in respect of the report, which Cabinet noted in making the decisions below:

a)     That Cabinet be advised that the recommendations be supported.

b)     That if additional work is required at Member level, the Cabinet Member for Adult Social Care and Health be recommended to approach the Health Select Commission to support such activity.

Resolved:-  (1)  That the Clinical Commissioning Group be designated as Lead Commissioner for the Community Occupational Therapy Service.

(2)  That the proposal to extend the contract for the Community Occupational Therapy Service for a period of up to 12 months from the 1st April 2017, for the reasons identified in Section 3 of this document, be noted.