Agenda item

(To receive a report by Marie Kaempfe-Rice, Senior Commercial and Procurement Officer – People Services, which invites the Committee to consider the Block Transitional Care and Reablement Beds Re-procurement which is due for decision by the Executive Councillor for Adult Care, Health and Children's Services between 2 – 9 December 2019)

Consideration was given to a report which invited the Committee to comment on a report on Block Transitional Care and Reablement Beds Re-Procurement, on which a decision was due to be made by the executive Councillor for Adult Care, Health and Children's Services between 2 and 9 December 2019.

It was reported that the procurement rounds undertaken in respect of the two separate lots of County Council beds and also on behalf of health partners (Lincolnshire's Clinical Commissioning Groups and Lincolnshire Community Health Services NHS Trust (LCHS)) resulted in contracts totalling 86 beds (35 LCC and 51 LCHC) as of August 2019.  This provision was situated within 26 care homes across the county.  There was a Section 75 agreement established and since 2016 the County Council had undertaken the contract management function for both Council and health contracts.

The initial term of these contracts had expired on 7 August 2019 and had subsequently been extended until 31 March 2020 to allow adequate time to review the service and options available in respect of a re-procurement of these services.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was planned to re-procure the contract on the same terms.  However, a new Section 75 agreement would be required.

·         It was commented that the benefit of having more beds in fewer locations could be seen, but from a service user perspective it was queried whether people would need to be travelling further from home, and how much of an impact would this have or was it too early to know?  It was acknowledged that it was too soon to know what the impact would be, but this was more about facilitating discharge from hospital and a temporary placement to help people regain their independence.  Where possible people would be supported to be as close to their home as possible.

·         It was noted that LCHS paid more than the County Council for beds, but now through joint procurement it would be better for all partners.

·         It was planned that there would be four locations with up to 20 beds.  The aim was to consolidate the available beds.

·         There was an aim to retain the same number of beds, but through a 'block purchase' approach rather than paying for 'spot purchase'.

·         There was due to be a residential rates review in the coming year, and therefore officers were not able to speculate on costs.

·         It was noted that in the south of the county, a lot of residents went to Peterborough hospital, and it was queried whether there would be any issues with discharging patients in this area.  Members were advised that there would not be any issues as the patients were Lincolnshire residents.

·         There would be a fixed number of beds within each home, based on flexibility about prevailing needs.  There was a need to know which beds would be most appropriate for people's needs as they were discharged.

·         The beds would exclusively be for placements by Lincolnshire County Council and the NHS.

·         It was queried whether if the room was unavailable or refused, would there be penalties.  It was noted that LCC would make void payments if the bed was unoccupied.  The home would be in breach of contract if it let the room to someone else.

·         It was queried whether there was a danger of reducing the number of beds available for general residential use.  Members were advised that these beds were for high need and were higher priority.  There would still be capacity elsewhere, but less choice.  This would specifically be looked at as part of the rates review.

·         The beds would be located in Lincoln, Gainsborough, Stamford, Grantham and Spalding.

·         It was noted that it was the bigger homes which were being looked at.  In the south of the county, it was acknowledged that there were problems with finding nursing beds.  Discussions were taking place with CCG's.

·         During 2020, between January and the autumn, members would have the opportunity to discuss market capacity and to also get a sense of how Lincolnshire fits into the national picture.

RESOLVED

1.    That the Committee support the recommendations to the Executive Councillor for Adult Care, Health and Children's Services as set out in the report.

2.    That the following comments be passed to the Executive Councillor for Adult Care, Health and Children's Services in relation to this item:

·         a key benefit of the procurement would be avoiding unnecessary admissions to hospital and allowing for the earlier discharge of patients from hospital;

·         transitional care and reablement beds would be available in several locations across Lincolnshire to meet service user needs, but more information on the detailed locations would be provided to the Committee; 

·         there would be an emphasis on improving capacity in the south of the county, where historically provision has been low; and

·         transferring patients from an acute hospital to a community hospital does not represent a hospital discharge, as patients in a community hospital would still be counted for the delayed transfer of care measure.