Agenda item

Antony Dixon, Strategic Commissioning Manager and Kate Lowman, Procurement Category Manager, Care and Support introduced the report to the Committee and highlighted the following issues:

(a)  The Care Support and Enablement framework was established in 2013 and runs until 2017. Providers are struggling to cope with the complexity of needs arising as a result of the transforming care agenda.

(b)  Nottingham and Nottinghamshire are a transforming care fast track site, testing the implementation of a new national model of care. There is an assumption from NHS England that needs will be managed in a community setting rather than a residential setting.

(c)  There is a projection that the programme will apply to around seven individuals, all of whom require high cost packages of care. The average cost of each placement is £2000 per week and one package is in the region of £5000 per week. The intention is that when contracts are re-tendered in 2017 both frameworks will be combined.

(d)  Funding of these placements is a matter of debate with NHS England. It has been suggested that a ‘dowry’ could accompany individuals on resettlement from acute care but this has not yet been resolved. Individual packages will continue to be approved through normal process. This report covers establishing the framework of providers.

During discussion with the Committee the following points were raised and responded to:

(e)  There is no budget to commission a service but when people come out of key care, the Council has budgetary responsibility for their care packages. With enhanced care, traditionally people with such complex needs have gone into residential or acute care settings. The existing framework was not designed to meet such complex needs. The new framework aims to manage particularly complex needs.

(f)  An advantage of going down the community care route is that it will reduce the number of out of area placements. The new framework will enable work to be done with local providers for to achieve a better controlled price. It is also hoped that the reduced use of institutional settings will reduce the frustration experienced by service users.

(g)  The number of individuals in institutional settings  changes frequently. Many have been in hospital settings for a long time and it is difficult to monitor. The current approach is to encourage providers to manage challenging behaviour in a community setting, rather than in institutions. Some individuals are still in institutions at Home Secretary’s discretion.

RESOLVED to

(1)  Approve the proposal to establish a Framework Agreement for Enhanced Care Support and Enablement, with the capacity of meeting the complex needs of citizens in the community. The framework will run for two years from inception.

(2)  Delegate authority to the Director of Procurement and Children’s Commissioning to award the outcome of the tender.

(3)  Delegate authority to the Head of Procurement and Contracting to award contracts.

Reasons for Recommendations

To develop a mechanism for swiftly identifying suitable providers with the tenacity experience, skills and robust processes required to deliver Enhanced Care Support and Enablement (CSE), to look after citizens with challenging behaviour and complex needs and respond appropriately when they present a risk. The current framework of CSE providers is unable to meet the high needs of this particular cohort of citizens. It is therefore necessary to develop a bespoke Framework for enhanced needs.

Other Options Considered

Utilise the current CSE framework. This option is not recommended as providers are unable to offer the level of service required within the current CSE Framework.