AGENDA ITEM NO. 9
REPORT TO: Executive Board
REPORT NO: CSSO/43/06
DATE: 17 October 2006
LEAD MEMBER: Councillor Rodney Skelland (Social Affairs, Health and Housing
LEAD OFFICER: Chief Social Services Officer
CONTACT OFFICER: Sheila Wentworth (298015)
SUBJECT: Community Equipment Service
WARD: All
1 PURPOSE OF THE REPORT
The purpose of the report is to
i) advise Members of the Welsh Assembly Government’s requirement
for the development of an integrated Community Equipment
Service(CES)
ii) to seek authorisation to progress towards a S31 Agreement (Health and Social Care Act 1999) for an integrated CES across NE Wales
iii) to seek agreement for a bid against the Capital Grant for the purchase of a new store.
2 EXECUTIVE SUMMARY
2.1 Over the past two years, significant work had been undertaken by officers of the Council to develop an integrated community equipment service with Flintshire.
2.2 More recently the development of such a service has been identified as a key target for health and social care agencies within the NSF for Older People.
2.3 In order to facilitate the development of an integrated Community Equipment Service, the Welsh Assembly government (WAG) are establishing a specific Capital Grant, with bids likely to be required by the end of October.
2.4 Allocation of grant funding is dependent on both the local authority and the Local Health Board agreeing to integrate the Community Equipment Service through a formal S31 Agreement for a pooled budget.
2.5 The NE Wales Community Equipment Service Executive Steering Group have identified as priority for the grant allocation – a bid for funding for a new store.
3 RECOMMENDATIONS
3.1 Members agree to progress work to achieve a S31 Agreement for a pooled budget for a NE Wales Community Equipment Service.
3.2 Members support the bid to the Capital Grant to fund new store.
REASONS FOR RECOMMENDATIONS
A pooled budget and integrated service will allow for maximum efficiencies and improved quality to service users
WAG will not release capital grant without this agreement.
There is a clearly identified need for a new store and all other major items identified by WAG as being eligible for funding have been acquired.
Andrew Figiel
Chief Social Services Officer
4 BACKGROUND INFORMATION
Community Equipment Store
4.1 At Health Housing and Social Affairs Scrutiny Committee on 8th December 2004 Members supported the approach to Integrated Working across a number of services.
4.2 One of these services was the Community Equipment Service (often referred to as Joint Stores) and Members endorsed the proposal to utilise funds within the Joint Working Special Grant to develop a Community Equipment Service across North East Wales
4.3 Effective community equipment services have become increasingly important in recent years as both the NHS and Social Services are supporting more highly dependent and vulnerable people in the community. Community equipment also plays a vital role in supporting the development and education of disabled children.
This places considerable demands on those staff who assess people for equipment and for those people providing care. They need to be supported by a professional community equipment service that is underpinned by:
· A clear competency framework to determine which staff can assess and prescribe which categories of community equipment.
· Effective systems for prescribing professionals to order equipment.
· Effective delivery, installation and demonstration of equipment.,
· Good procurement practice boosted by improved purchasing power through agencies working together.
· Effective arrangements for servicing, collection and decontamination of equipment.
· Efficient control of stock and effective tracking of equipment.
· Effective arrangements for recycling and for exchanging or selling on specialist items of equipment through the mechanism of a virtual store
4.4 The defining characteristics of an integrated community equipment service include:
· Revenue funding from pooled health and local authority contributions.
· Facilities which are multi-purpose and flexible to accommodate shared use across the wide range of health, social care, statutory, and the voluntary sector organisations.
· A single operational manager.
· A board to advise the manager, whose members are accountable to the organisation from which they come and which includes:
· Local Authority and NHS commissioners
· Representatives from professionals who assess equipment needs
· A substantial proportion of representatives from user, carer and voluntary organisations
· All aspects of the infrastructure reflect the unified approach and build on existing structures and systems. New infrastructure developments are generic, where possible, to provide maximum capacity and flexibility.
· Single inventory with unified stock with the practical distinctions between “NHS” and “social services” equipment removed as it affects the service user.
· Good quality management information systems and shared data.
4.5 Agencies and staff will benefit from a new integrated service organisation structure through:-
· Cost effective efficient service from economies of scale
· Pooled budgets enabling bulk buying of equipment at more economical rates
· Pooled equipment stock enabling sharing of resource
· Ability to release valuable/costly North East Wales Trust and Wrexham and Flintshire Social Care clinician, professional practitioner/assessor time by transferring equipment related work to Stores eg equipment recall, recovery, cleaning and repair
· Support to NHS, housing, social care and education practitioner interventions eg rehab, manual handling, continuing care at home
· Assistance to statutory services to carry out their duties in compliance with relevant legislation
· A whole system approach avoiding duplication and providing a bridge to the gap between hospital and home and prevention of buck passing or the migration of responsibilities between services
· A combined Health and Social Care audit trail
· Management information and information on performance targets
· A system which will secure public engagement
· Effective and efficient use of resources to best effect
4.6 A Steering group, comprising senior officers from Wrexham and Flintshire Social Services Departments, Wrexham and Flintshire LHBs and NEW Trust have already made significant progress in respect of the above.
4.7 They have been supported in this work by Project Groups comprising middle managers working together with representatives from the voluntary sector, service users and carers.
4.8 Workshops, facilitated by Welsh Assembly Government in Autumn 2005 in anticipation of the S.31 requirement illustrated that North East Wales were well positioned to meet the criteria and implementation time-table for an Integrated Community Equipment Store
4.9 Thus far they have developed
· A Project Plan for an integrated Community Equipment Service
· A Joint Management Structure
· Commenced transfer of equipment related services from an external company to Stores eg Equipment decontamination for North East Wales Trust Occupational Therapy Department
· Procured and implemented a new e-technology Joint Stores IT Management System
· Commenced compilation of a joint equipment catalogue in progress
· Reviewed Children’s Equipment Service provision by a dedicated cross-Agency Sub Group whose recommendations now form an Action Plan
4.10 The area of work yet to be achieved is that in respect of the “Facilities”.
It was seen that as community assessment activity with children and adults increases amongst Occupational Therapists as well as District Nurses and Physiotherapists, the capacity for the storage of equipment is at a premium in both stores. The problem being amplified as other services see the benefits of tracking, tracing and recycling, for example hearing and visually impaired equipment services. Extra capacity is required to store, deliver and collect manual handling equipment as a result of the impact of the manual handling operation regulations on the work of social care staff.
Capital Grant
4.11 Welsh Assembly Government intend to make capital funding of £12.5m available in 2006/07 and 2007/08 with £1,119,882 to be allocated to North East Wales in total (£557,141 to Wrexham, £562,741 to Flintshire). A suitable location for this service is being sought within the finance available from WAG
4.12 The criteria for funding stipulates that the money can only be utilised to improve the infrastructure to support and develop effective, joined up community equipment services.
4.13 A condition for release of the Capital Grant is that both the Local Health Board and the Local Authority agree to integrate community equipment services.
5. CONSULTATION
5.1 Service users, carers and the voluntary sector are represented on the Project Groups
5.2 The Strategic Partnership Board on July 26th noted and supported progress towards integration
6. SCRUTINY COMMITTEE COMMENTS
6.1 Health, Social Affairs and Housing Scrutiny Committee on October 11th considered the WAG requirement to a S31 Agreement and the bid for Capital Grant funding for a new store.
7. IMPLICATIONS
7.1 Policy Framework
Provision of a community equipment service meets the key health, social care and well being strategic priorities for Adults and Children’s Services through promoting independence and supporting people at home.
7.2 Budget
In 2005/2006 the combined Flintshire and Wrexham gross budget was £543k
Of this Wrexham’s budget was £270k.
The Trust made contributions to these budgets. No additional revenue costs are identified at this time. The bid from WAG is for Capital funding.
7.3 Legal
The National Service Framework for Older People has identified for each local health and social care community one key action to be achieved by March 2007 as “the development of integrated commissioning plans for the provision of aids and equipment services in line with commissioning guidance” and by March 2008 for these to be implemented through a S.31 Agreement for Integrated Provision, and a Pooled Budget.
7.4 Staffing
It is anticipated that all staff will become part of the new integrated community equipment service.
Policies and procedures developed for the establishment of the S31 Agreement for integrated Learning Disabilities and Mental Health Services will provide a valuable framework and templates.
However, the necessity to pool budgets may require TUPE regulations to come into play.
Union representatives are being kept informed of progress and will be brought into more detailed discussion at the appropriate time.
7.5 Other
7.5.1 Agreement to a S31 Pooled Budget carries inevitable risk through the necessity to ring-fence monies through a pooled budget.
7.5.2 Finance representation will be crucial on the Steering Group, whilst legal Services will support the formulation of the NE Wales version of WAG template for S31 Agreement.
7.5.3 Scrutiny Committee will be kept fully informed of progress with final agreement to S31 Partnership to be endorsed by the Executive Board.
7.5.4 Consideration will be given alongside this development, to the potential for further collaboration across North Wales.
1. Integrated Working CSSO/05/03
2. Integrated Working Mental Health and Learning Disabilities CSSO/37/04
3. Flexibilities Grant CSSO/11/02
4. Integrated Working CSSO/39/04s
5. Community Equipment Service CSSO/39/06s
6. WAG Letter re Community Equipment Service Capital Grant Allocation and Conditions / www.wrexham.gov.uk
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