Contact: Yvonne Le Brun, ext 7790

1 Summary

1.1 That the Revised eligibility criteria for continuing NHS health care, recently produced by the Health Authority in consultation with Primary Care Trusts and Local Authorities be agreed and the Executive Member be advised of the financial impact and monitoring arrangements in due course.

2 Reason(s)

2.1 The Coughlan judgement (1999) required Health Authorities to review continuing care policies to ensure they are compliant with this important judgement. Requires agreement by Local Authorities.

3 Other options considered and rejected

3.1 None

4 Conflicts of Interest declared by the decision-maker or a Member or Officer consulted

4.1 Councillor Mrs Felicity Hindson is the HCC appointed nominee on Winchester and Central Hampshire CHC

5 Dispensation granted by the Standards Committee

5.1 None

6 Reason(s) for the matter being dealt with if urgent

6.1 Not applicable

Approved by: Date of decision:

Councillor Felicity Hindson

Contact: Yvonne Le Brun Ext: 7790

Background

This paper sets out the proposed Eligibility Criteria for Continuing NHS Health Care and proposals for the development of standardised assessment tools to support judgements in determining eligibility criteria for continuing care and the appeals procedures and proposed training.

Context

In June 2001 HSC/2001/015: LAC(2001)18 Continuing Care: NHS and Local Authorities Guidance was published. The purpose of the document was to:

· Consolidate guidance on continuing NHS health care in the light of the judgement of the Court of Appeal in R v Northeast Devon Health Authority exparte Coughlan (1999)

· Ensure that NHS and local councils agree together how they will meet continuing health and social care needs bearing in mind that local councils responsibility for providing care by a registered nurse in a nursing home will be removed by section 49 of the Health and Social Care Act 2001

· Update and review the complaints procedures for continuing care.

· Reflect the establishment of Primary Care Trusts; the duty of co-operation under section 26 of the Health Act 1999; the section 31 Health Act 1999 flexibilities to promote joint working between NHS and local government, and the availability of Care Trusts provided by the Health and Social Care Act 2001.

· Whilst an initial implementation date of 1.4.02 was expected, it has now been put back to 1.10.02. PCTs must abide by this new criteria from this date and with local authorities need to consider action required to re-assess existing service users.

Action taken:

· Health Authorities were asked to ensure that their continuing care policies complied with the above guidance. In anticipation of the formation of the new Strategic Health Authority the three predecessor Health Authorities agreed that a single document should be written to be adopted across the new Health Authority boundary.

· A steering group was set up with representatives across the 3 former Health Authorities, the 4 Local Authorities, the PCTs and Winchester and Central Hampshire Community Health Council. This group was supported by a project manager funded and managed by health.

· Key stakeholders, including health and social care commissioners, clinicians and care managers were identified to develop the principles and values underpinning the new criteria. A series of workshops across the county addressed these issues in March this year.

This work led to the development of the draft criteria which were produced in April and formed the basis for consultation with wider stakeholders. The document has been reviewed by our legal services department, as well as Bevan Ashford solicitors (who represented Miss Coughlan) on behalf of the Strategic Health Authority. A copy of the current document is attached.

· Work is taking place on developing standardised assessment tools for use with each care group to ensure equity of access across the Health Authority area. The development groups have "expert" workers across health and social care and are involving carers & users in their formation.

· A single appeals procedure has been developed as well as a guide for patients and carers. The preferred option to deal with appeals is via PCTs and to seek local resolutions. The Health Authority will deal with process complaints rather than service delivery issues.

Next Steps

· Following agreement by the Local Authorities a formal policy will be produced and published for distribution.

· A launch of the new policy and related training is required. We were asked, on behalf of the Strategic Health Authority, to devise a programme of joint training for health and social care staff within Hampshire. The programme is attached (in draft) and it is being offered to Local Authorities and PCTs outside Hampshire County Council boundaries. Funding for this training will be sought from the Workforce Confederation training budget.

· Future training or eligibility criteria for our staff has been amended to include the new criteria and a revised two day training to incorporate Fair Access to Care Services will be in place from April 2003. We are currently negotiating with health to offer that on a joint basis.

· The financial impact and possible related savings to the department need to be quantified and is currently being evaluated.

Recommendations

1. That the new Continuing Care Criteria is agreed.

2. The Executive member be advised in due course of financial impact and monitoring arrangements.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act

None