Meeting of Lanarkshire Board Lanarkshire Board Kirklands 28 th September 2011 Fallside Road Bothwell G71 8BB Telephone 01698 855500 www.nhslanarkshire.org.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 August 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 Nursing 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 August 2011
The expenditure for the period 1 st April to 30 th June 2011 (Appendix 1) was noted. 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. Work continues with 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. An implementation plan is being developed and will be considered by the Board. s with Hatton Lea and Cumbernauld Nursing Home have been operating on a rolling year by year contract. Further assessment is being undertaken to consider next steps to ensure more robust and contemporary contractual arrangements. The level of requirement for inpatient provision will be clarified following the review of Mental Health Services. Discussion continues in relation to the establishment of contractual arrangements with Strathcarron Hospice to ensure they are funded 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 Assurance has been provided from the Social work and social care improvement Scotland (SWSCIS) that the Memorandum of Understanding for, previously established with the, will continue to be effective until the new organisation can establish a revised 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 SWSCIS states that the following Lanarkshire contract premises are not subject to any enforcement/prohibition action. Carrickstone House Hatton Lea Park Springs Cumbernauld St Andrews Hospice Strathcarron Hospice Huntercombe Services Murdostoun- The Brain Injury Rehabilitation Centre
The issue of fire precautions in Nursing Homes is the subject of a separate paper to the Lanarkshire Board. 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. Arrangements are being put in place to transfer the responsibility for provision from homes currently operated by Southern Cross Healthcare as it will cease trading in late 2011. Assurances have been given in respect of Parksprings that new arrangements will be in place by late September/early October. This process is being monitored by the National Contingency Planning Group/COSLA. An Action Plan developed by Carrickstone Nursing Home following a SWSCIS visit is to be reviewed against the Board s Policy on s. 4. CONCLUSION Currently all contracts are within budget and delivering the specified. The next meeting of the Review Group will take place in February 2012 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 February 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 Nursing Workforce 01698 206352 margaret.maccallum@lanarkshire.scot.nhs.uk IAN A ROSS DIRECTOR OF STRATEGIC IMPLEMENTATION PLANNING AND PERFORMANCE
Appendix 1 The Register June 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 Inpatient continuing care old age medicine and intermediate care 35 care home beds The initial contract period of 1997 2007 has been extended until March 2014 Fixed term contract which will expire on that date / Nursing / led Yes SWSCIS Emergency and Medicine Directorate 1345 335
BUPA Homes Hatton Lea Nursing Home, Bellshill Four Seasons Health Ltd Cumbernauld Nursing Home Cumbernauld Inpatient continuing care old age psychiatry Inpatient continuing care old age psychiatry 75 beds (contract value for 90 beds) 52 beds The initial contract period of 1993 2003 has been extended annually 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. / Nursing / / led Yes SWSCIS & Mental Welfare Yes SWSCIS & Mental Welfare 2543 634 1462 365
Park Springs Inpatient continuing care 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 Council Residential home 6 beds The contract period is from 2008 to 2012. Fixed term contract and can be extended to 2014 by giving notice by Sept 2012 Annual Review Rolling Rolling contract / Nursing Nursing social care staff led Yes SWSCIS Emergency and Medicine Directorate No SWSCIS Emergency and Medicine Directorate Yes SWSCIS South East Unit Yes SWSCIS South East Unit 670 167 16 1 1923 481 506 125 Bobath Scotland Glasgow G4 9UD Childrens Cerebral Palsy Therapy Centre Specialist multi disciplinary therapy for children with No SWSCIS Head of 50 22
cerebral palsy / Nursing led 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 SWSCIS Unit North East Non SWSCIS Unit North East 140 0 68 68 BPAS Liverpool & London Consultation/ termination of pregnancy hospital Non Quality Head of 21 0 Capability Scotland Perth Learning Physical Sensory Impairment - will cease when flat in E/K is ready (Aug 6) Non SWSCIS Head of Acute 23 6
Central Scotland Brain Injury Rehabilitation Centre, Inpatient brain injury rehabilitation Centre / Nursing led Non SWSCIS & Mental Welfare Head of 410 0 Rosshall Hospital Glasgow Multiple Sclerosis Partnerships In, Ayr Clinic, Ayr Non acute Hospital Services Support s for people affected by Multiple Sclerosis Outreach clinic at Lady Home 1 day twice a month Inpatient Low secure forensic s - Female only low secure unit / male & female IPCU Hospital Voluntary provider Cost per Case Annual Contribution Non SWSCIS Head of Planning Acute No No Head of Non SWSCIS 0 21 37 37 750 222
Huntercombe Hospital, Edinburgh Inpatient adolescent eating disorders unit/ Child & adolescent Psychiatry hospital. Usage has reduced with the development of s within L / Nursing led Non SWSCIS Mental Welfare Quality network for inpatient child and adolescent Services 478 101 National Autistic Society, Bristol Notre Dame Centre, Glasgow Supported Living Paediatric counselling and psychiatric assessment Clinic No MH & LD residents currently with this No No Quality Head of No No SWSCIS Head of 166 54 64 7 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 Nursing staff No SWSCIS 300 72
Daldorch House School Ayrshire Specialist Autism Spectrum Disorder Service/ Learning Difficulties Services for under 18 s Specialist Health Services including Nursing, Medical and Allied health Services/ Residential / Educational Support Scottish government On- Going No MH & LD residents currently with this / Nursing led Yes SWSCIS 0 20 Quarriers, Bridge of Weir The Priory Hospital, Glasgow Clinovia/ Now owned by BUPA Epilepsy assessment and video telemetry Inpatient eating disorders, drug and alcohol rehabilitation psychology therapies Health care at home s (TPN) hospital hospital Supplier yes SWSCIS Head of Planning Acute Non SWSCIS Head of Planning Health Board No No No Chief Pharmacist Lanarkshire 130 0 101 0 94 17
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 nursing staff led Non Non Quality Quality 0 52 0 14 6spot purchase contracts less than 8k Clinics/Suppliers Head of (11) 10 Total 11287 2831