Meeting of Lanarkshire Board Lanarkshire Board 14 Beckford Street Hamilton ML3 0TA Telephone 01698 281313 Fax 01698 423134 www.nhslanarkshire.co.uk SUBJECT: MONITORING OF HEALTH CARE CONTRACTS WITH INDEPENDENT SECTOR PROVIDERS 1. PURPOSE To inform the Board on the issues and actions in relation to Monitoring of Health s held by Lanarkshire with Sector Providers following the meeting of the Review Group held in February 2011. 2. CONTENT/SUMMARY OF KEY ISSUES 2.1 Background The Lanarkshire policy on managing health care contracts with the Sector providers was approved by the Board in May 2009. The policy enabled the establishment of a contract review group for performance oversight and to report to the Board, through the Director of Strategic Implementation, Planning and Performance. Membership of the group includes the Director of and NMAHPs and the Employee Director. In addition individual managers who have direct responsibility for managing Healthcare s are members of the group 2.2 Review Group The Review Group was established with the following remit: to review current Lanarkshire contract performance against all contracts; to review and develop the Board s contracting processes; to review the Memorandum of Understanding with the and to ensure effective governance arrangements 3. ACTIONS The following issues and actions were identified at the meeting of the Review Group held in February 2011
The register along with expenditure for 20010/2011 (Appendix 1) was noted. The contract register provides a brief description of the and the designated contract manager. Further work has been undertaken to clearly define the role and responsibilities of the s. The quality assurance arrangements have been strengthened by the development of a monitoring template. This is completed by the twice yearly for each Healthcare and submitted to the Review Group for scrutiny. The template layout will be reviewed annually to ensure all relevant information is captured. Work has been undertaken to consider the redesign of the brain injury rehabilitation s. The redesigned would provide a community based which would reduce the need for patients to be cared for in the independent sector as inpatients. However, implementation of the redesigned requires to be managed within the financial envelope. A business case is being drafted for further consideration. s with Hatton Lea and Cumbernauld Home have been operating on a rolling year by year contract. Further assessment is being undertaken to consider next steps to ensure more robust contractual arrangements but which enables the potential change to the requirement for inpatient provision that may follow the review of Services. Further work is required in relation to budgetary reporting in relation to Healthcare s. This work will be undertaken and completed for the beginning of the new financial year. Further discussion is to be undertaken in relation to the establishment of contracted costs with Strathcarron Hospice to ensure they are established on a basis that complies with current guidance. Occupancy levels at both Strathcarron and St Andrew s Hospice will be considered further and discussions will be held with both establishments A redesign stakeholder workshop has been undertaken regarding the provision of Bobath s. Bobath is a charity based in Glasgow providing support to children with cystic fibrosis. This has been looking at developing s within Lanarkshire to save patient travel. Work to establish a revised is ongoing at present. The continued use and potential development of Quarriers Hospital is the subject of a group established with all Boards in the West of Scotland. The group will report its findings to the West of Scotland Regional Planning Group. Assurance has been sought from the that the Memorandum of Understanding for will continue to be in place until the new organisation Social and Social Work Improvement Scotland establish a new Memorandum of Understanding. The group acknowledged that whilst the original contract documentation requires review and updating this should be considered in the context of future strategy on bed requirements as it would be
counter-productive to undertake this in isolation from potential reduction in bed requirements. Information from Strathclyde Fire & Rescue and the states that the following Lanarkshire contract premises: Carrickstone House Home Hatton Lea Home Park Springs Home Cumbernauld Home St Andrews Hospice Strathcarron Hospice Huntercombe Services Murdostoun- The Brain Injury Rehabilitation Centre are not subject to any enforcement/prohibition action. Further work to be undertaken to develop an assurance regime for short term call off contracts for healthcare s outside of the boundaries of Lanarkshire. 4. CONCLUSION Currently all contracts are within budget and delivering the specified. The next meeting of the Review Group will take place in August 2011 when the above issues will have been taken forward with a clear action plan in place to address any ongoing work. A further briefing will be provided to the Board following the August meeting. The Board is requested to note the current position in regard to s with Sector Providers. For further information about any aspect of this paper please contact Margaret Maccallum, Associate Director of Workforce 01698 206352 margaret.maccallum@lanarkshire.scot.nhs.uk IAN A ROSS DIRECTOR OF STRATEGIC IMPLEMENTATION PLANNING AND PERFORMANCE
Appendix 1 The Register FEBRUARY 2011 ` Lanarkshire Health Providers and the contract monitoring arrangements The is responsible for regulating the independent healthcare sector and securing quality of care. However, certain s are not subject to regulation. The quality of these s must be monitored through the contract management process. The care has a responsibility to all patients in the independent sector, whether or not their treatment is funded by the. The provides external monitoring of independent healthcare providers to ensure they provide appropriate standards of. It also investigates complaints about s and allegations that standards have not been met. Provider Specialties Type of Four Seasons Health Ltd Carrickstone House & Day Hospital Cumbernauld BUPA Homes Hatton Lea Home, Bellshill Inpatient continuing care old age medicine and intermediate care Inpatient continuing care old age psychiatry Home 35 care home beds Home 75 beds (contract The initial contract period of 1997 2007 has been extended until March 2014 Fixed term contract which will expire on that date The initial contract period of 1993 2003 has been extended annually / / / led Yes Yes the & Mental Welfare Emergency and Medicine Directorate 1545 1,166 2543 1850
Four Seasons Health Ltd Cumbernauld Home Cumbernauld Inpatient continuing care old age psychiatry value for 90 beds) Home 52 beds on a rolling basis since 2003 pending the outcome of a review of Mental Health s. 1 year s notice of contract expiry on the anniversary of commencement date. The contract period is from 1992 2007. Further extension to the contract will be dependent on the outcome of a review of Mental Health s.1 year s notice of contract expiry on the anniversary of commencement date. / / led Yes the & Mental Welfare 1462 1071 Park Springs Inpatient continuing care Home The contract period is from 2008 to 2012. Fixed term Yes Emergency 641 485
North Lanarkshire Council St Andrew s Hospice Airdrie Strathcarron Hospice Stirlingshire Intermediate care Inpatient palliative care and continuing care old age medicine. Day care palliative care Inpatient and Day palliative care 48 beds contract and can be extended to 2014 by giving notice by Sept 2012 Council Annual Review Residential home 10 beds Home Home Rolling Rolling contract / social care staff led No Yes Yes the and Medicine Directorate Emergency and Medicine Directorate South East Unit South Unit East 26 20 1923 1442 506 379 Bobath Scotland Glasgow G4 9UD Childrens Cerebral Palsy Therapy Centre Specialist multi disciplinary therapy for children with cerebral palsy No 40 23
/ led the Silverton Respite Rachel & Robin Houses Specialist in Autism, Cerebral Palsy, Epilepsy, Head/Brain Injury, Hearing and Visual Impairment Palliative care for children and young adults Inpatient and respite care care home Two children s hospices and Home care care home Annual contribution to South Lanarkshire Council Annual Health Board Contribution of 12.5% of running costs managed by Tayside HB No No Non Unit North East Unit North East 140 0 68 67 BPAS Liverpool & London Consultation/ termination of pregnancy hospital Non Quality 0 8 Capability Scotland Perth Learning Physical Sensory Impairment Home - will cease when flat in E/K is ready (Aug 6) Non Acute 28 19
/ led the St. Andrews Northampton Forensic Old Age Psychiatry Hospital individual deceased prior to repatriation to L no MH & LD residents since 24/1/11 Non Quality 170 128 Central Scotland Brain Injury Rehabilitation Centre, Inpatient brain injury rehabilitation Centre Non & Mental Welfare 410 203 Multiple Sclerosis Support s for people affected by Multiple Sclerosis Outreach clinic at Lady Home 1 Voluntary provider Annual Contribution No No 37 37
Partnerships In, Ayr Clinic, Ayr day twice a month Inpatient Low secure forensic s - Female only low secure unit / male & female IPCU Home / led Non the 750 1020 Huntercombe Hospital, Edinburgh Inpatient adolescent eating disorders unit/ Child & adolescent Psychiatry hospital. Usage has reduced with the development of s within L Non Mental Welfare Quality network for inpatient child and adolescent Services 553 184 National Autistic Society, Bristol Notre Dame Centre, Glasgow Supported Living Paediatric counselling and psychiatric assessment Home Clinic No MH & LD residents currently with this No No Quality No No 128 124 64 18
/ led the Wasthills Autistic Centre Castlebeck (Teesdale) Ltd Co Durham Specialist Autism Spectrum Disorder Service/ Learning Difficulties Services Specialist Health Services/ Residential / Challenging behaviour assessment & Rehabilitation reviewed on 6 monthly basis staff No 287 240 Daldorch House School Ayrshire Specialist Autism Spectrum Disorder Service/ Learning Difficulties Services for under 18 s Specialist Health Services including, Medical and Allied health Services/ Residential / Educational Support Scottish government On- Going No MH & LD residents currently with this Yes 0 20 Quarriers, Bridge of Weir The Priory Hospital, Glasgow Epilepsy assessment and video telemetry Inpatient eating disorders, drug and alcohol hospital hospital yes Non Head Planning Acute of Planning Health Board 130 0 101 0
Clinovia/ Now owned by BUPA rehabilitation psychology therapies Health care at home s (TPN) Supplier / led the No No No Chief Pharmacist Lanarkshire 94 18 Blackburn Clinic (part of Partnerships in ) Surehaven, Glasgow Forensic Psychiatry Low secure inpatient male & female accommodation Clinic hospital (related to one patient admitted on 21/12/09 and subsequently transferred to Ayr Clinic on 27/05/10 nursing staff Non Non Quality Quality 0 52 0 59 National Autistic Society Challenging behaviour autistic unit Unit nursing staff Non Quality 0 165
Lancaster 10 spot purchase contracts less than 8k Clinics/Supplier s / led the (62) 23 Total 11646 8798