Archived decisions

Agenda Item 1

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1 That Hampshire County Council enters into a Section 75 Agreement with Hampshire Primary Care Trust to deliver an Integrated Community Equipment Service to the citizens of Hampshire

2) Issues Covered in Report:

2.1 The parameters of the Agreement with key clauses identified

2.2 The background and contextual information relating to the establishment of an integrated equipment service

2.3 The impact and implications of entering into the agreement

3) Recommendations:

3.1 That Hampshire County Council enters into a Section 75 Agreement with Hampshire Primary Care Trust to deliver an Integrated Community Equipment Service to the citizens of Hampshire.

3.2 We are seeking approval by the Executive Member to agree delegated authority to the Director of Adult Services to confirm the final wording of the Section 75 agreement

3.3 That as part of this agreement, the County Council agrees to meet half of the financial contribution to provide this service which is £1,736,126 per annum at 2008/09 costs, for the duration of the agreement.

MAIN REPORT

1) Purpose of the Report:

1.1 The Section 75 Agreement is undertaken in accordance with the NHS Act 2006. The agreement sets out the parameters in which ICES will operate on behalf of both partner organisations and operated by the County Council.

1.2 The agreement covers:

· The aims of the service

· The duration of the agreement

· Governance

· Management of the service

· The pooled funding arrangements

· Capital expenditure

· Audit arrangements

· Liabilities and insurances

· Commissioning

· Performance monitoring and management

· Early termination

· Termination reconciliation

· Winding down

· Complaints

1.3 Along with the main topics above, the agreement outlines the specific requirements that the service must meet to ensure the agreement is executed in accordance with the agreement of both parties. These are laid out in seven schedules located at the end of report that cover:

· Description of service provided

· Financial contributions

· The Terms of Reference of the ICES Board

· The information sharing protocol

· Service standards and performance measurement

· The terms of reference of the performance management group

· The terms of reference of the professional user group

1.4 The process of managing the agreement will be through the ICES Board which will give governance to the agreement. Representation at the Board includes senior managers from both organisations along with representation from Hampshire Coalition of Disabled people.

1.5 The Service supports two of the corporate priorities; Hampshire safer and more secure for all and maximising well-being. It does so through the timely provision of equipment to citizens who are disabled and frail in all service areas including older people, adults and children within Hampshire. The range of equipment purchased and stocked is essential to enable people to remain within their own homes or within a community based setting. Most of the equipment is re-used and re-issued.

1.6 The service promotes independence and wellbeing and is central to safe and timely hospital discharges. The provision of equipment prevents hospital, residential or nursing home admissions by minimising the risks of falls, immobility and breakdown of formal or informal care arrangements.

2) Contextual Information:

2.1 The Section 75 Agreement has been in existence for approximately six years during which time the County Council has worked with a number of Primary Care Trusts's (PCT's) across Hampshire, moving more recently to one Hampshire Primary Care Trust (HPCT). Over the past 18 months the service has been developed to deliver positive improvements to the equipment provision for the citizens of Hampshire.

2.2 Hampshire County Council has operated varying levels of community equipment provision for a number of years in a variety of formats. More recently, with strong working partnerships with HPCT the new Hampshire Integrated service has relocated to a new and improved site in Basingstoke bringing all of community equipment provision and the provision of a high quality training services for professionals throughout the County, under one service hosted by the County Council.

2.3 ICES is also linked to the telephone service, OT (Occupational Therapy) Direct. Those callers to this service, who meet the County Council's Eligibility Criteria and require simple equipment that they can fit themselves, are passed directly to ICES. An example is Mrs B. who telephoned OT Direct on behalf of her Mother, who could no longer sit down in her bath. OT Direct put her through to ICES who supplied a bath board - a piece of equipment that allows an individual to use the bath without having to sit down in it. The equipment was delivered to Mrs B within 48 hours of her call, with simple instructions, and she was able to install it for her Mother thereby helping to maintain her independence.

2.4 If a person has more complex needs, an Occupational Therapist will assess the individual and pass the request for equipment to ICES. This equipment will then be delivered and installed by ICES staff or by a supplier from the County Councils approved list.

2.5 Many people with very complex needs are supported to stay at home through the use of equipment from ICES. It is particularly valuable to those who wish to avoid admission to residential or nursing home care or are at the end of their lives and wish to remain at home. The kind of packages of equipment that can be used in these circumstances are hi-low beds (£1,000), high risk mattresses (£3,200), mobile hoist (£1,300) and a sling (£250).

2.6 ICES provides very good value through re-use of equipment, in line with guidelines provided by The Medicines and Healthcare products Regulatory Agency (DB2003(06) Community Equipment Loan Stores - Guidance on Decontamination). During 2007/08, ICES delivered 53,320 pieces of equipment to the value of £7.8M. This was achieved on a budget of £3.5M through efficient and effective re-use.

2.7 The service is offering a high level of performance for both partner organisations it is felt that ICES will provide a effective platform to develop the Personalisation agenda over the coming year.

2.8 The Section 75 agreement will formally confirm the joint working arrangements and covers the period from 1 April 2008 until the 31 March 2013 with early termination clauses.

2.9 The Leader of the Council will be officially opening the service on Thursday 30 October, 2008.

3) Key Issues:

3.1 The key clauses contained in the agreement are around the aims and objectives of the service, the duration of the agreement, the performance management of the service, the early termination of the agreement, termination reconciliation, winding down and Schedule 2 - finance.

3.2 On the 30 March 2007 the Executive Member for Adult Social Care agreed that:

· Hampshire County Council establishes a single Integrated Community Equipment Service located in Basingstoke

· Hampshire County Council and Hampshire PCT terminate their partnership agreement with Portsmouth City PCT and Portsmouth City

· The potential costs associated with the premises move are met by prioritising the existing capital budget.

· A Section 75 Agreement is entered into with Hampshire PCT incorporating a robust funding strategy to meet the demands on the service and including the Technician Service.

This report is submitted at a time where these options have been achieved.

4) Financial

4.1 Commitment to finances of £1,736,126 (at 08/09 costs). This constitutes 50 % of the funding which the County Council will agree to meet. The remaining 50% of the funding will be met by the PCT under this agreement. Within the Section 75 agreement clear risk sharing arrangements are in place.

4.2 Inflation will be financed and a standard rate recommended annually by the ICES Board and applied by the Partners directly to the service budgets.

5. Legal

5.1 The full agreement has been reviewed by the County Council's Legal Services in March 2007 and reviewed in June 2007. All of the current amendments to the document have been included in this final version of the Section 75 Agreement with further additions being explored with the County Council's Legal Services on the inclusion of a robust approach to apportion staff and capital costs in the event of the agreement not continuing at the end of the five year period.

6) Personnel

6.1 With agreements reached through the ICES Board the establishment within the current ICES has increased. The service has all core posts in place and some ongoing recruitment is currently taking place. The service now employs within the region of 55 FTE posts. Recruitment and interest of applicants for the service is deemed to be good.

7) Outline of Options:

7.1 Option 1: Approval is given for the formal partnership to continue under a signed Section 75 Agreement.

This will enable to service to continue to provide it's high level of delivery to citizens in a formal way with governance coming from the ICES Board.

7.2 Option 2: Approval is not given.

This could place the partnership at risk of dispute and may result in the service not providing adequate community equipment provision, in a formal way, to citizens of Hampshire.

8) Conclusion:

8.1 We are now at a stage where we are seeking Executive Member approval to enter into a five year formal agreement for the provision of an Integrated Community Equipment Service.

9) Summary Recommendation:

9.1 That Hampshire County Council enters into a Section 75 Agreement with Hampshire Primary Care Trust to deliver an Integrated Community Equipment Service to the citizens of Hampshire.

9.2 We are seeking approval by the Executive Member to agree delegated authority to the Director of Adult Services to confirm the final wording of the Section 75 agreement

9.3 That as part of this agreement, the County Council agrees to meet half of the financial contribution to provide this service which is £1,736,126 per annum at 2008/09 costs, for the duration of the agreement.

Integral Appendix A

CORPORATE OR LEGAL INFORMATION: