Purpose

Reason for the decision:
 
It is the
ambition of KCC for the people in Kent to have home-based care and
support services, in line with Home First principles. Discharge
Pathway 1 Services enable the Council to deliver towards this
ambition. The pathway relates to people being discharged from
hospital with home-based support; all people needing such support
should be offered reablement and rehabilitation and, where
necessary, time for assessment and future care planning. This
includes people whose package of care is being restarted after
lapsing during their hospital stay.
 
The Discharge to Assess Service
Contract was commissioned by Kent County Council (KCC) and forms
part of Discharge Pathway 1 Service, for people discharged from
hospital who need support to recover at home. Across Kent, there
are a few other services that also align with the pathway,
commissioned by the Integrated Care Board (ICB) and other health
partners.
 
Discussions between KCC and the
ICB resulted in in principle agreement to a new model, but more
time is needed to undertake appropriate governance and subsequent
implementation. 
 

Options (other options considered but
discarded)

 
Do nothing – if
the contract terminates this would impact on people who require
support at home in the early days post discharge, the Discharge to
Assess activity would transfer to higher costs services and the gap
in service provision would impact on delayed hospital
discharges.
 
Financial Implications
 
This is a demand-led
service and activity can fluctuate. The annual budget for the
Discharge to Assess is £2,953,400 with additional budget of
£732,600 for bridging.  The
service’s forecast spend this year is £3,928,400; an
overspend of £242,400. 
 
If the contract is
extended by nine months, it is anticipated that costs of the
extension will be circa £2,970,000 (based on current
activity) and within the budget for the service.
 
Historically, the ICB
has financed additional Discharge to Assess capacities (for example
from NHSE winter funding); the ability to incorporate additional
funding, including from the ICB, over and above the KCC budget
allocation will still be available within the extension
period.
 

Decision

As Leader of the
Council, I agree to:
 

a)   
APPROVE the Direct Award the Discharge to Assess Service
Contract to the incumbent provider (Hilton Nursing Partners) for up
to nine months from 1 January 2024 to 30 September 2024 and

 

b)   
DELEGATE authority to the Corporate Director Adult Social
Care and Health to take other relevant actions, including but not
limited to finalising the terms of and entering into required
contracts or other legal agreements, as necessary to implement the
decision.