Archived decisions
Hampshire County Council
Executive Member for Social Care Item 1
20 June 2003.
Report of the Director of Social Services
Nursing Care Investment Strategy - Agreements under Section 31 of the Health Act 1999 and Section 28A of the NHS Act 1977
Contact: Andrew Brooker. Ext 7281
1. Introduction
1.1 Members of the Cabinet on 28 October 2002 supported a proposal to seek capital funding to create additional nursing care capacity in Hampshire in partnership with the Hampshire and Isle of Wight Strategic Health Authority.
1.2 In order for the County Council to manage nursing care homes it is necessary to form a partnership agreement with each of the 7 Primary Care Trusts in Hampshire under Section 31 (2) (c) of the Health Act 1999. This allows for the NHS nursing functions, defined in Section 3 (1) of the NHS Act 1977, to be transferred to a partnership within which the Local Authority is enabled to deliver nursing care in a residential setting.
1.3 It is also proposed that the appropriate Primary Care Trust will make a capital grant to the County Council under Section 28A of the NHS Act 1977 for the cost of construction and for any necessary purchase of NHS land.
1.4 This report seeks the necessary authority to enter into a Section 31 partnership agreement with the 7 PCT s in Hampshire and also to enter into Section 28A agreements for land purchase and construction costs.
2 Partnership arrangements
2.1 Two key partnership arrangements are being forged between the County Council and NHS organisations in Hampshire.
· Firstly a partnership between the County Council, The Hampshire and Isle of Wight Strategic Health Authority, Primary Care Trusts and NHS Trusts in relation to land and capital.
· Secondly a partnership between the County Council and the 7 Primary Care Trusts in Hampshire for the operation of nursing care homes
2.2 Within the land and capital partnership it is proposed that the County Council and NHS organisations make land available for extensions and new buildings and that £40m is made available via the Strategic Health Authority to support construction costs. Cabinet on the 23 June will consider options to raise the remaining £20m capital requirement needed to complete the strategy to create an additional 500 nursing care places and for the necessary refurbishment to existing HCC homes where extensions are being considered.
2.3 Whilst the negotiations to make land and capital available have included Primary Care Trusts, Hospital Trusts and the Strategic Health Authority it will be necessary for the appropriate Primary Care Trust to make a capital grant to the County Council under Section 28A of the NHS Act 1977 to support construction costs for any development in their area. These grant Agreements will contain arrangements to protect NHS land and assets created with NHS capital for future NHS use should the nursing care service not be required in the future or the partnership is ended.
2.4 Section 31 (2) (c) of the Health Act 1999 authorises the forming of partnerships between NHS bodies and Local Authorities which would enable, inter alia, the delegation of functions from one body to another.
2.5 Legal Opinion has been obtained which confirms the legal basis for the County Council to form a partnership with PCT s for the purpose of transferring the nursing function to the Local Authority under Section 31 (2) (c) of the Health Act 1999.
2.6 The proposed partnership with the 7 Primary Care Trusts in Hampshire supports the County Council's policies to sustain a mixed economy of care provision by developing nursing care services within residential homes to be managed by the Authority.
2.7 Additional capacity created in this way will provide for better access to care services to support vulnerable older people whose nursing needs can not be met in their own homes and will also support the joint target with the NHS to reduce the level of delayed transfers of care in acute and community hospitals.
2.8 The guidance for reaching Section 31 agreements requires consultation with stakeholders and a consultation paper has been widely circulated within the existing public forums in each PCT area in Hampshire. The partnership proposal has also been made available to County Wide organisations including the Hampshire Care Association, local Councils of Voluntary Action, Carer and Consumers groups, Community Health Councils and NHS Hospital Trusts in Hampshire and in surrounding Authorities. The proposals have also been made available to the Local Authority and NHS Staff representative organisations.
2.9 Where extensions to existing County Council residential care homes are being considered, meetings have been held for staff, residents and relatives. A number of comments have been received regarding the potential disruption to residents during construction work which can be addressed as any contracts are agreed. In general residents and relatives supported the proposals as existing residents might benefit from improvements to their surroundings and from the reassurance that nursing care would be available if the needs of residents changed in the future. The views of existing staff included concerns for the recruitment and retention of additional staff and support for the potential of better career development opportunities within the new service. Both of these issues will be addressed in the workforce strategy being developed with NHS partners.
2.10 Each PCT Board has now received a report noting any comments made during consultation and has confirmed agreement in principle to entering into a partnership with the County Council. A draft agreement setting out responsibilities and purpose has been made available and it is intended to seek the authority of each PCT Board in June and July 2003 for an agreement to be signed.
2.11 Within these partnerships the County Council will be able to offer a range of nursing care services to older people in homes registered with the National Care Standards Commission. These services could include long stay care, respite care, and Intermediate Care for physically frail older people and for older people with dementia. The National Care Standards Commission have confirmed their support of the separate registration of nursing care services in extensions to existing services and to the use of shared kitchen and laundry facilities on some sites.
2.12 The partnership agreement will also enable the Council to offer continuing care to older people who are the responsibility of the NHS due to their level of need, in these cases the NHS will be financially responsible for the cost of care. In all cases the Primary Care Trusts will be responsible for determining the level of financial contribution the NHS should make towards the cost of nursing care. (currently within a range between £40 and £120 per week)
2 Summary
3.1 The DoH has been able to confirm capital funding of £40m over 2003/4 and 2004/5 to support the creation of additional nursing care services and Members of the Cabinet will consider a report on the 23 June identifying options for raising the remaining £20m capital requirement to create 500 places by 2005/6.
3.2 Site feasibility studies are being completed and it is intended to make planning applications on 11 sites that could potentially be developed within the capital limit and timescales agreed between partners. To date planning applications have been made in respect of extensions at Ticehurst residential care home in Aldershot, at Oakridge in Basingstoke and in relation to a site in the ownership of the Fareham and Gosport PCT at the former Coldeast Hospital in Fareham. In all cases public consultation events will be held and arrangements made to seek the views of local NHS staff. Once the outcome of these and subsequent planning applications are known it will be possible to determine a development schedule within which it is intended to commence construction in late 2003 with the first places being available late 2004.
3.3 The necessary public consultation has been undertaken in order to form agreements within Section 31 of the Health Act 1999 and PCT Boards are considering their support to partnership agreement which are intended to be in place during the summer of 2003 to support construction contracts being let later in the year.
4. Recommendations
4.1 That the Executive Member approves the proposed partnership between the County Council and the 7 PCT s under Section 31 (2) (c) of the Health Act 1999 and the signing of the partnership agreement on behalf of the County Council by an authorised signatory.
4.2 That the Executive Member approves the proposed grants to the County Council under Section 28A of the NHS Act 1977 and the signing of the agreements on behalf of the County Council by an authorised signatory.
Section 100D - Local Government Act 1972 - background papers
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 includes:
1. published works
2. Documents which disclose exempt or confidential information as defined in the Act.
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