Agenda item

Care at Night Service

Report of the Executive Director, People Services.

Decision:

12.1

The Executive Director, People Services, submitted a report requesting authority and approval for Sheffield City Council (“SCC”) to jointly commission with Sheffield Clinical Commissioning Group (“SCCG”) for the provision of a revised night visiting service, called ‘Care at Night’. 

 

 

12.2

RESOLVED: That Cabinet:- 

 

 

 

(a)

approves the recommendations made by the Executive Management Group (“EMG”) of the Better Care Fund, on 5th September 2018, in relation to the commissioning, contracting, financial and risk arrangements for the Care at Night service which will be, subject to approvals and agreement from both SCC and SCCG, covered and funded under the existing Framework Partnership Agreement relating to the Commissioning of Health and Social Care Services (“S75 Agreement”); with EMG’s recommendations including:  

 

(i) approval for a revised night visiting service (now called “Care at Night”) to be jointly commissioned between SCC and SCCG;

 

(ii) approval for the Care at Night service to be managed on a ‘Jointly Managed Scheme – Integrated Commissioning Arrangements’ basis within the S75 agreement; and

 

                 (iii) approval for the costs of the jointly commissioned contract   for the Care at Night service to be shared between SCC and SCCG on a fixed % contribution basis which is expected to deliver a 50:50 sharing of the modelled savings.  The proportionate share of costs would be split into 60% SCC and 40% SCCG.  The risk-share for any future increase in costs, such as additional rounds, will be in line with the percentage splits above.

 

 

 

 

(b)

delegates authority to:-

 

 

 

 

 

(i)

the Executive Director, People Services, in consultation with the Director of Finance and Commercial Services and the Director of Legal and Governance, to vary the S75 Agreement and any other necessary documentation that are required in order to give effect to the implementation of the EMG’s recommendations as set out above;

 

 

 

 

 

 

(ii)

the Director of Finance and Commercial Services, in consultation with the Executive Director, People Services, to procure the proposed service and approve the procurement strategy; and

 

 

 

 

 

 

(iii)

the Executive Director, People Services, in consultation with the Director of Finance and Commercial Services and the Director of Legal and Governance to:-

 

(A) approve the terms of the variation to the S75 Agreement and enter into all necessary documents (such as deed of variation) in order to add the Care at Night service to the S75 Agreement, in line with this report;

 

(B) approve the terms and enter into the new contract for the Care at Night service; and

 

(C) take all other necessary steps not covered by existing delegations to achieve the outcomes outlined in this report.

 

 

12.3

Reasons for Decision

 

 

12.3.1

The proposed jointly commissioned Care at Night service will aim to achieve the following outcomes:

 

  • Individuals benefit from continuity of care without the need to change care provider should their eligibility for CHC services change.

 

  • Individuals and their families have a strong voice enabled through provider-led regular quality check surveys which helps to monitor service quality and inform continual service improvement.

 

  • People are supported to get home more quickly from hospital by providing short-term support, including wraparound care as required.

 

  • Systemic pressures are reduced and better outcomes for people achieved, for example, by enabling a family carer to have a short break or get a good night’s sleep, without the cost and upheaval associated with admitting the cared for person to a care home.

 

  • The service represents value for money with service costs reflective of both the market value and the health and social care activities being delivered.

 

  • Savings for SCC and SCCG are potentially achieved.

 

  • New ways of joint working are tested as a staging post on the journey to fully integrated commissioning, by working through the challenges and capturing the lessons learned on a relatively small project.

 

  • A unified, consistent approach to pricing and contract management for night care is implemented.

 

·         A platform for further potential developments is created, for example incorporating the overnight elements of the CWCA and Intensive Home Nursing Service, which may realise additional structural benefits and citywide savings in future, and deliver a better experience for users.

 

 

12.4

Alternatives Considered and Rejected

 

 

12.4.1

Do not provide a night care service after the existing contract is due to expire at the end of March 2019:  This is not a viable option.  The individuals requiring care and support during the night are often among our most vulnerable citizens.  While opportunities to increase independence and reduce the amount of care required will be actively explored as part of the new arrangement, not having any night care in place is likely to result in individuals being placed in residential settings or being admitted to hospital, which is not acceptable from an operational perspective, nor a reasonable or desirable outcome for individuals and their families.

 

 

12.4.2

Procure contracts separately from the CCG:  For the reasons outlined elsewhere in the report, to continue to procure contracts separately removes the opportunity to make collective savings and deliver a more efficient service which is better for individual users, and contradicts the national direction of greater integration of health and social care services.

 

 

12.5

Any Interest Declared or Dispensation Granted

 

 

 

None

 

 

12.6

Reason for Exemption if Public/Press Excluded During Consideration

 

 

 

None

 

 

12.7

Respective Director Responsible for Implementation

 

 

 

Jayne Ludlam, Executive Director, People Services

 

 

12.8

Relevant Scrutiny and Policy Development Committee If Decision Called In

 

 

 

Healthier Communities and Adult Social Care

 

 

 

 

Minutes:

12.1

The Executive Director, People Services, submitted a report requesting authority and approval for Sheffield City Council (“SCC”) to jointly commission with Sheffield Clinical Commissioning Group (“SCCG”) for the provision of a revised night visiting service, called ‘Care at Night’. 

 

 

12.2

RESOLVED: That Cabinet:- 

 

 

 

(a)

approves the recommendations made by the Executive Management Group (“EMG”) of the Better Care Fund, on 5th September 2018, in relation to the commissioning, contracting, financial and risk arrangements for the Care at Night service which will be, subject to approvals and agreement from both SCC and SCCG, covered and funded under the existing Framework Partnership Agreement relating to the Commissioning of Health and Social Care Services (“S75 Agreement”); with EMG’s recommendations including:  

 

(i) approval for a revised night visiting service (now called “Care at Night”) to be jointly commissioned between SCC and SCCG;

 

(ii) approval for the Care at Night service to be managed on a ‘Jointly Managed Scheme – Integrated Commissioning Arrangements’ basis within the S75 agreement; and

 

                 (iii) approval for the costs of the jointly commissioned contract   for the Care at Night service to be shared between SCC and SCCG on a fixed % contribution basis which is expected to deliver a 50:50 sharing of the modelled savings.  The proportionate share of costs would be split into 60% SCC and 40% SCCG.  The risk-share for any future increase in costs, such as additional rounds, will be in line with the percentage splits above.

 

 

 

 

(b)

delegates authority to:-

 

 

 

 

 

(i)

the Executive Director, People Services, in consultation with the Director of Finance and Commercial Services and the Director of Legal and Governance, to vary the S75 Agreement and any other necessary documentation that are required in order to give effect to the implementation of the EMG’s recommendations as set out above;

 

 

 

 

 

 

(ii)

the Director of Finance and Commercial Services, in consultation with the Executive Director, People Services, to procure the proposed service and approve the procurement strategy; and

 

 

 

 

 

 

(iii)

the Executive Director, People Services, in consultation with the Director of Finance and Commercial Services and the Director of Legal and Governance, to:-

 

(A) approve the terms of the variation to the S75 Agreement and enter into all necessary documents (such as deed of variation) in order to add the Care at Night service to the S75 Agreement, in line with this report;

 

(B) approve the terms and enter into the new contract for the Care at Night service; and

 

(C) take all other necessary steps not covered by existing delegations to achieve the outcomes outlined in this report.

 

 

12.3

Reasons for Decision

 

 

12.3.1

The proposed jointly commissioned Care at Night service will aim to achieve the following outcomes:

 

  • Individuals benefit from continuity of care without the need to change care provider should their eligibility for CHC services change.

 

  • Individuals and their families have a strong voice enabled through provider-led regular quality check surveys which helps to monitor service quality and inform continual service improvement.

 

  • People are supported to get home more quickly from hospital by providing short-term support, including wraparound care as required.

 

  • Systemic pressures are reduced and better outcomes for people achieved, for example, by enabling a family carer to have a short break or get a good night’s sleep, without the cost and upheaval associated with admitting the cared for person to a care home.

 

  • The service represents value for money with service costs reflective of both the market value and the health and social care activities being delivered.

 

  • Savings for SCC and SCCG are potentially achieved.

 

  • New ways of joint working are tested as a staging post on the journey to fully integrated commissioning, by working through the challenges and capturing the lessons learned on a relatively small project.

 

  • A unified, consistent approach to pricing and contract management for night care is implemented.

 

·         A platform for further potential developments is created, for example incorporating the overnight elements of the CWCA and Intensive Home Nursing Service, which may realise additional structural benefits and citywide savings in future, and deliver a better experience for users.

 

 

12.4

Alternatives Considered and Rejected

 

 

12.4.1

Do not provide a night care service after the existing contract is due to expire at the end of March 2019:  This is not a viable option.  The individuals requiring care and support during the night are often among our most vulnerable citizens.  While opportunities to increase independence and reduce the amount of care required will be actively explored as part of the new arrangement, not having any night care in place is likely to result in individuals being placed in residential settings or being admitted to hospital, which is not acceptable from an operational perspective, nor a reasonable or desirable outcome for individuals and their families.

 

 

12.4.2

Procure contracts separately from the CCG:  For the reasons outlined elsewhere in the report, to continue to procure contracts separately removes the opportunity to make collective savings and deliver a more efficient service which is better for individual users, and contradicts the national direction of greater integration of health and social care services.

 

 

 

 

Supporting documents: