To receive a presentation from the Assistant Director - Strategic Commissioning.
The Deep Dive for this meeting was Learning Disability Partnership Arrangements.
The presentation was delivered by the Senior Commissioning Manager - Learning Disability/Mental Health/Autism and covered the following:
· The Risk – 3 Key Factors
1. Uncertainty on financial resource transfer into the health and social care economy in Cumbria.
2. A lack of availability of suitable and affordable service and support providers and limited capacity within existing service and support providers.
3. Failure to meet statutory requirements leading to reputational damage to the Council and individuals not having their care and support needs met close to home.
· Quarter 2 Risk Rating
· Quarter 3 Risk Rating
A member sought assurance regarding the best way to support someone who may need in-patient treatment. The Senior Commissioning Manager reported that the Edenwood NHS assessment and treatment service had 6 places to cover all of Cumbria. He explained that there was also an enhanced community model service now in place to address issues with admittance and by working to this new model, the team had prevented 12 hospital admissions that at one time would have been inevitable. The Senior Commissioning Manager assured members that if a person was assessed and needed hospital in–patient treatment then they would get it, but the concern was that in the past, people were being admitted to hospital only because there was not any other option.
A member asked to what extent new providers had embraced the ‘Step-up, Step down’ process and the new framework and questioned whether the team were confident with using it in the future. The Senior Commissioning Manager informed members of the work that the team had carried out with the 32 providers currently on the additional needs Framework. A recent summit had been held with all providers which had helped to create a much more open dialogue about the Council’s requirements and helped develop an understanding of provider needs. It was clarified that of the 32 providers which had now agreed to this framework, 16 of them were new to partnership arrangements with the Council.
In response to a question regarding the current risk rating the Senior Commissioning Manager assured members that one of the key objectives of the commissioning service was to build good relationships with providers based on a genuine partnership approach and ensure quality provision which in turn would further reduce the Council’s exposure to risk.
Members were informed that before putting in place the additional needs Framework, the service identified an estimated 75 people who were potentially in need of some form of support. There were an estimated 30 people identified as living out of county. The Senior Commissioning Manager clarified that the wider objective of the additional needs framework would be to provide for those who genuinely presented a challenge to how they were supported and whose needs could not be met through general domiciliary care and may need more specialist support.
After a question which sought clarification about the role of local providers, members heard about ‘Small Supports’ a strategy which focussed on supporting local people develop their own business which would consequently help in building the market.
Discussion took place about the length of hospital stays for those admitted with additional needs. The length of stay often varied depending on the individual, it was clarified that the average stay was approximately 3 months, however a number of people remained in hospital for longer.
The Chair considered the new approach to be refreshing and suggested that when the controls were reviewed, that the Corporate Management Team had good reason for reviewing the Risk rating. She also observed that the more effective the interventions were that the County Council puts in place to provide support to individuals, the more the associated financial pressure moved from the NHS to the County Council.
The Chair thanked the Senior Commissioning Manager for the informative presentation and welcomed that controls were in place to address the risks identified.
RESOLVED that, the position be noted