Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1 This report seeks approval for making two grants to the Stroke Association in the financial year 2008/9 to commission research into the incidence, needs and services for stroke survivors and their carers and the involvement of survivors and their carers in that research. The grants will be made from the Department of Health ring-fenced funding for 2008/9 provided to Hampshire County Council to implement the social care elements of the National Stroke Strategy.

2) Issues Covered in Report:

2.1 Details of the level of funding sought by The Stroke Association and the reasons for the funding.

2.2 Background information relating to the National Stroke Strategy and the context for this report.

3) Recommendations:

It is recommended that:

3.1. That the Executive Member for Adult Social Care approve a grant of £19,080 to the Stroke Association for research into the incidence and variety of social care support services and their quality and outputs for stroke survivors in Hampshire.

3.2. That the Executive Member for Adult Social Care approve a grant of £5,920 to the Stroke Association for enabling stroke survivors and their carers to be directly involved in the research carried out by the Association.

MAIN REPORT

1) Purpose of the Report:

1.1. The first purpose of this report is in respect of a grant application received from the Stroke Association for research into the incidence, nature, variety, quality and output of social care support services for stroke survivors and their carers in all parts of the county of Hampshire.

1.2. The second purpose of this report is in respect of a grant application received from the Stroke Association in relation to enabling stroke survivors to be directly involved in the above research.

2) Contextual Information:

2.1. Stroke is the leading cause of long-term severe disability in the United Kingdom and affects significant numbers of the service users and carers for whom Adult Services provide social care and support.

2.2. In response to the National Stroke Strategy, in Hampshire we have a developing Stroke Care Pathway which Hampshire Adult Services Department (HASD) have been involved in developing with Hampshire Primary Care Trust (HPCT) and other partners. The provision of high quality social care is of fundamental importance to the success of the Stroke Care Pathway.

2.3. Detailed work is currently underway, led by HPCT, to specify the services needed to deliver the full stroke care pathway across Hampshire. The Stroke Care Pathway starts with prevention, moves through early acute medical care, specialist rehabilitation both in hospital and in the community, social care support, long-term monitoring through to life in the community.

2.4. Local Authority Circular DH 2008 2 issued on 7 May 2008 requires social care departments to ensure the delivery of `support services to stroke survivors and their carers' and provides a ring-fenced grant to Hampshire County Council, value £145,000 per annum over three years to deliver this.

2.5. In partnership with HPCT and providers, HASD is developing a package of responses to fulfil the requirements of the circular. These two grants represent a small part of the overall package but will provide significantly better data on stroke survivors and their carers in Hampshire. The whole package currently includes;

· The recruitment of four half-time Occupational Therapists who will be `stroke specialists' and will focus their work on the interface between health and social care that is so critical for stroke survivors and their families.

· Commissioning from The Stroke Association two new Communication Support Groups in the New Forest and East Hampshire as part of their `Lost without words' campaign.

· Consolidation of existing grants to support groups in the county

· Research into the incidence and needs of stroke survivors to enable targeted commissioning and service development.

· The involvement of stroke survivors and their carers in the development of services.

· The development of performance indicators and long-term data collection for the purposes of social care commissioning.

2.6. The principles defined and agreed in the Hampshire strategy include:

a) care that is personalised.

b) appropriately trained specialist staff at all stages of the pathway.

c) ensuring that people who have had a stroke and their carers are meaningfully involved in the planning, development, delivery and monitoring of services.

2.7. The historical development of community-based services in the county to support stroke survivors and their families has been both piecemeal and patchy. Some or both are funded by H.A.S.D and H.P.C.T without providing equality of access across the whole county.

2.8. For details of existing communication support groups and social care support groups see http://www.stroke.org.uk/in_your_area/south_east/south_central/index.html There are currently 5 communication support groups plus groups in both Southampton and Portsmouth and 15 social care support groups in the county.

2.9. The developing Hampshire Stroke Strategy supported by the National Stroke Strategy provides the opportunity both to consolidate and increase the right services for those in need at any stage of the care pathway. It provides the opportunity to ensure equality of access throughout the county as well as individual personalised services.

2.10. The long-term outcomes across both health and social care are expected to be a reduction in the incidence of strokes as well as a reduction in their impact, similar to the improvements that have been achieved nationally in cardiac care.

3) Key Issues:

3.1. The Stroke Association is the only independent non-statutory specialist agency working with people who have had strokes. They already provide a number of both communication groups and support groups in the county - grant funded by this authority for £17,670.

3.2. Although there is an indication from national research of the social care needs of stroke survivors and their carers and indeed this is covered by the Local Authority Circular; there is little local data about current needs or support required. It is not possible to gather this from existing departmental data as diagnoses are not necessarily recorded.

3.3. These two grants together provide both the quantitive data in respect of need and services to meet need, as well as the qualitative input from service users and carers on these services.

3.4. This data, combined, will enable both this authority and the HPCT working in partnership, to commission a range of support services to meet the needs of people who have survived a stroke and their carers.

3.5. These two grants are part of a wider package of measures that are being developed to meet the needs of stroke survivors, however they are the necessary precursor to the full development of a Hampshire Stroke Strategy.

3.6. These two grants are specifically designed to ensure that by the research and provision of social care data in respect of the needs of stroke survivors, the authority is able to play its full role in partnership with HPCT while maintaining its focus on social care provision.

4) Financial Implications:

4.1. These two grants will both be met from the first year of the new Stroke Grant (totalling £145,000 per annum for three years) made available to the authority as part of LAC DH 2008 2.

5) Risk Assessment:

5.1. The interface or division between NHS rehabilitation and The Adult Service's Department re-ablement services is blurred. With this comes the risk that the new grant could be used to fund NHS deficits rather than meeting social care needs. However, it is known that for a person who has survived a stroke there are a myriad of interconnected support needs. Working closely with HPCT, who also fund The Stroke Association for local services, to ensure that the locally agreed pathway of care is delivered, there is no risk in respect of these two grants that they are supporting gaps in NHS funding.

5.2. There is a risk that Adult Services Department will not be able to evidence the impact of the extra funding because of poor baseline data about this service user group and their needs. This is a strong possibility given our current access to relevant data. Agreement of the proposals contained in this report will significantly contribute to ensuring that this is not a significant risk.

6) Equality Impact Assessment

6.1. The two grants proposed in this report will provide accurate data which does not at present exist. This will enable future service development to be accurately targeted, non-discriminatory and provide equal access across the county of Hampshire.

7) Outline of Options:

7.1. Not applicable - however the acquisition of essential data will provide a range of options for future service developments.

8) Conclusions:

8.1. These two grants together will provide the foundation for the future development of person-centred and equally accessible services across the whole county for those who have survived a stroke and their carers.

8.2. The above development will form an essential part of the Hampshire Stroke Care Pathway which is being developed by H.P.C.T. in partnership with this Department and will provide a complete health and social care pathway in respect of a stroke.

9) Recommendations:

Please see Executive Summary for recommendations.

CORPORATE OR LEGAL INFORMATION: