Date 5/5/09. Date 5/5/09. Date 5/5/09. Date 5/5/09 Name of TU rep. Date. Date 5/5/09. Date 6/5/09. Date 6/5/09. Date 11/05/09.

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1 DELEGATED POWERS REPORT NO. 812 SUBJECT: Request to Outsource Occupational Therapy Assessment currently on the waiting list. Control sheet All of the following actions MUST be completed at each stage of the process and the signed and dated report MUST be passed to Democratic Service for publishing All reports 1. Democratic Services receive draft report Name of DSO Nick Musgrove 2. Democratic Services cleared draft report as being constitutionally appropriate 3. Finance clearance obtained (report author to complete) 4. Staff and other resources issues clearance obtained 5. Trade Union response received (Staffing issues only) 6. Legal clearance obtained from (report author to complete) 7. Policy & Partnerships clearance obtained 8. Equalities & Diversity clearance obtained 9. The above process has been checked and verified by Director, Head of Service or Deputy 10. Signed & dated report, scanned or hard copy received by Democratic Services for publishing 11. Report published by Dem Services to website Name of Fin. officer Andrew Filby Name of Res. officer Jacquie McGeachie, Name of TU rep. Name of Legal officer Patricia Davila Name of P&P officer Andrew Nathan 6/5/09 Name of officer Julie Pal 6/5/09 Name Irene Findlay 11/05/09 11/5/09 11/5/09 Officer reports: 12. Head of Service informed report is published and can be implemented. Name of DSO Cabinet Member reports: 13. Expiry of call-in period 14. Report circulated for call-in purposes to COSC Name of DSO members & copied to Cabinet & Head of Service Nick Musgrove 11/5/09

2 ACTION TAKEN UNDER DELEGATED POWERS BY OFFICER (EXECUTIVE FUNCTION) Subject Officer taking decision Improving capacity to complete occupational therapy assessments in order to reduce the waiting list. Director of Adult Social Services of decision 11 May 2009 Summary Officer Contributors Status (public or exempt) Wards affected Enclosures This report gives approval to occupational therapy assessments for people currently on the waiting list being completed by an external agency. Senel Arkut (Service Manager Hospitals and Rehabilitation Older Adults) Public All None Contact for further information: Senel Arkut Ext 4262 Serial No.812

3 1. RELEVANT PREVIOUS DECISIONS 1.1 Cabinet Decision 15 January : Choice and Independence A Vision for Adult Social Services -.adoption of strategic vision, for adult social services. 1.2 On 18 June 2007 Cabinet agreed an Action Plan for the delivery of the Vision. 1.3 The Integrated Commissioning Strategy for Older People in Barnet 2007 agreed by Cabinet 12 December CORPORATE PRIORITIES AND POLICY CONSIDERATIONS 2.1 The Vision document of Adult Social Services is committed to delivering greater choice and control for people in all areas of their lives to support the Corporate Priority of Supporting the Vulnerable. 2.2 The Integrated Commissioning Strategy for Older People makes commitments to increase access to aids and adaptations that make life safer, both through improved signposting for those people who wish to purchase their own, as well as those who require an Occupational Therapy (OT) assessment and provision of more specialist equipment. Target areas include reducing falls, and improving mobility. 3. RISK MANAGEMENT ISSUES 3.1 I have considered whether the issues involved are likely to raise significant levels of public concern or give rise to policy considerations and they do not. 3.2 Potential risks to the Council if we fail to take the recommended action include; Clients on the waiting list deteriorating and needing hospital admission Clients deteriorating and needing more support putting extra pressure on equipment and home care budgets Failing our duties of meeting need in a timely and safe manner Failing to deliver the department s vision of Independence Choice and Control. 3.3 The specification for the service will state quality standards required and occupational therapy managers will be monitoring the quality of the assessments. 4. EQUALITIES AND DIVERSITY ISSUES 4.1 Currently we have 370 people on the waiting list, waiting for OT assessments. Urgent action to carry out these assessments will enable us to provide an equitable service to all who are assessed to be eligible under FACS criteria. Currently we are limited to provide timely assessment to those in Critical need only. 5. USE OF RESOURCES IMPLICATIONS (Finance, Procurement, Performance & Value for Money, Staffing, IT, Property, Sustainability) 5.1 Social services have considered recruiting locum OTs to work specifically on the waiting list. However, there is a severe shortage, and hourly rates have increased from 28ph to 35ph. The NHS is paying up to 40ph. The calculations prove that

4 assessments being completed by a recognised agency are value for money, and will provide timely assessments for clients. 5.2 From experience of managing locums, and workloads, 100 cases would take two locum OTs minimum of 8 weeks which would cost 20,160, based on the Agency costs of 35 ph. 5.3 Assessments for 100 people by an agency will take 4 weeks and will cost 17,000. This will include booking appointments, assessments, form filling, ordering equipment, following up service users by phone, redirecting service users to other appropriate preventative resources, sending care plans and handover meetings with the service. Management overheads are included. 5.4 The waiting list is continuing to increase, and will, firstly, almost certainly be above the 370 quoted in this report once the Agency starts its work, and secondly, be added to by new referrals during the period in which the Agency is removing the backlog. This, coupled with the likely need for additional follow up appointments for certain individuals, has resulted in an estimated cost of 80,000 to contribute to removing the waiting list. Authorisation has been received to make a 80,000 contribution from 2008/09 Adult Social Services budget into an earmarked reserve that can be drawn down during 2009/10 to fund these costs as required. 6. LEGAL ISSUES 6.1 An external agency has been selected for the purpose of providing the occupational therapy service. As the contract value is less than 500,000, selection was carried out on the basis of "a reasonable means of selection" in accordance with Table 7-1 (Authorisation, Acceptance Thresholds and tendering requirements for Social Care) of the Council's Contract Procedure Rules. 7. CONSTITUTIONAL POWERS 7.1 Part 3 responsibility for functions, sections 6.1 and 6.2, powers delegated to officers. 8. BACKGROUND INFORMATION 8.1 Currently the OT team has 370 cases on the waiting list. 8.2 In 2005 the waiting list was reduced from 1400 to 0 and this was sustained until Over the last year the OT service has had problems keeping up with the workloads, hence the waiting list has been steadily rising. 8.3 The department has failed to recruit to vacant positions. There are currently 6 vacancies. Both OT + OT Assistant vacant posts have a permanent advert online. 8.4 The OT team has lost 3 experienced OT s within the last month and 1 OT is on maternity leave. 8.5 Currently, there are no locums available. The shortage of OTs is a national problem. OTs from other countries are not coming to work in the UK due to the economic situation.

5 9. LIST OF BACKGROUND PAPERS 9.1 None 10. OFFICER S DECISION I authorise the following action 10.1 That permission is given to the occupational therapy service for occupational therapy assessments to be completed by an external agency, as set out above, subject to the completion of legal and any other necessary documentation. Signed Signed by Irene Findlay Director of Adult Social Services 11 May 2009