Issue - meetings

Purpose

1.    To update Cabinet (following the reports in June 2020 and March 2021) on the delivery of the Health and Care Portsmouth vision for developing a local integrated intermediate care offer which offers Discharge to Assess, (D2A) rehabilitation, reablement and recovery support, primarily in people's home and in community beds where necessary that meets the needs of Portsmouth citizens.

2.    To seek the necessary approvals to enable Adult Social Care to work with Health & Care partners in the city to permanently establish a Discharge to Assess unit comprising beds within Harry Sotnick House.

RECOMMENDED that the Cabinet:

1.    Agree to the permanent transfer of the staff and related available budgets for the Victory Unit to Harry Sotnick House, acknowledging that this will result in Adult Social Care ceasing use of the Victory Unit at Wyllie Road.

2.    Agree that the Director of Adult Care consider and evaluate options for the use future of the space at Wyllie Road.

3.    Acknowledge that it has been possible to establish and operate the new Discharge to Assess unit within Harry Sotnick House at the current capacity, due to a combination of both the staff resources from the Victory Unit and the funding available through the governments temporary COVID Hospital Discharge Scheme.

4.    Acknowledge that health & care system partners have an ambition to establish a permanent 40-bedded D2A unit at HSH and that this proposal would require joint commissioning with and permanent funding contributions from Portsmouth CCG.

5.    Agree that the Director of Adult Care continue negotiations and enter into the necessary agreements with Health & Care partners, in consultation with the s.151 officer and the City Solicitor, (or their delegates) to establish:

             i.        A permanent jointly funded and commissioned D2A unit within Harry Sotnick House.

            ii.        Operational and funding arrangements to support people discharged from hospital, who cannot be supported within the D2A unit and require support from within the external care market, prior to a Care Act assessment being completed.

1.    Agreed to the permanent transfer of the staff and related available budgets for the Victory Unit to Harry Sotnick House, acknowledging that this will result in Adult Social Care ceasing use of the Victory Unit at Wyllie Road.

2.    Agreed that the Director of Adult Care consider and evaluate options for the use future of the space at Wyllie Road.

3.    Acknowledged that it has been possible to establish and operate the new Discharge to Assess unit within Harry Sotnick House at the current capacity, due to a combination of both the staff resources from the Victory Unit and the funding available through the governments temporary COVID Hospital Discharge Scheme.

4.    Acknowledged that health & care system partners have an ambition to establish a permanent 40-bedded D2A unit at HSH and that this proposal would require joint commissioning with and permanent funding contributions from Portsmouth CCG.

5.    Agreed that the Director of Adult Care continue negotiations and enter into the necessary agreements with Health & Care partners, in consultation with the s.151 officer and the City Solicitor, (or their delegates) to establish:

             i.        A permanent jointly funded and commissioned D2A unit within Harry Sotnick House.

            ii.        Operational and funding arrangements to support people discharged from hospital, who cannot be supported within the D2A unit and require support from within the external care market, prior to a Care Act assessment being completed.

The purpose report for the Chief Health & Care Portsmouth by the Assistant Director Adult Social Care is to:

* Update Cabinet on the response by Adult Services to the updated guidance of the 16th April 2020 providing the 14 day isolation period for people prior to entering a care home longer term.

* Describe how the Health and Care Portsmouth response to providing additional bedded capacity for a possible second peak in COVID-19 infections.

* Seek endorsement to continue exploring options to for a future long term Discharge to Assess Unit within Harry Sotnick House.

RECOMMENDED that Cabinet:

(1)  Endorse the continued operation of the 20 bedded 14 Day isolation unit in the HSH Gun Wharf Unit, recognising that this is dependent on continued funding from the temporary NHS Hospital Discharge Scheme.

(2)  Endorse the expansion of the unit by a further 26 beds for D2A should there be a need as a consequence of a second COVID-19 peak, recognising that this will be dependent on additional funding from the temporary NHS Hospital Discharge Scheme.

(3)  Endorse continued work to develop plans to transition the 20 Gun Wharf COVID beds to a mainstream Discharge to Assess unit, recognising that this would be part of a wider system change. It should also be acknowledged that this will require a more detailed financial appraisal, together with a retargeting of existing funding sources and potentially financial contributions from the wider health and care system partners; to ensure it is financially sustainable in the longer term. A further report will be presented to Cabinet once the final costings and funding sources have been identified in order to seek formal agreement to establish the unit.

Cabinet:

(1)  Endorsed the continued operation of the 20 bedded 14 Day isolation unit in the HSH Gun Wharf Unit, recognising that this is dependent on continued funding from the temporary NHS Hospital Discharge Scheme.

(2)  Endorsed the expansion of the unit by a further 26 beds for D2A should there be a need as a consequence of a second COVID-19 peak, recognising that this will be dependent on additional funding from the temporary NHS Hospital Discharge Scheme.

(3)  Endorsed continued work to develop plans to transition the 20 Gun Wharf COVID beds to a mainstream Discharge to Assess unit, recognising that this would be part of a wider system change. It should also be acknowledged that this will require a more detailed financial appraisal, together with a retargeting of existing funding sources and potentially financial contributions from the wider health and care system partners; to ensure it is financially sustainable in the longer term. A further report will be presented to Cabinet once the final costings and funding sources have been identified in order to seek formal agreement to establish the unit.