At its meeting on 27 June, 2018, the Adult Care and Health Overview and Scrutiny Committee referred the Scrutiny Review on Continuing Health Care to the Cabinet. The Overview and Scrutiny Committee minute, report to the Committee and Scrutiny Review are attached.

Councillor Chris Jones introduced a report of the Chair and Members of the Adult Care and Health Overview & Scrutiny Committee Task and Finish Group on the Continuing Healthcare Scrutiny Review.  The report set out the findings and recommendations arising from a Scrutiny Review completed in May 2018.  The Review had been commissioned as part of the former People Overview & Scrutiny Committee’s Work Programme – later the Adult Care and Health Overview & Scrutiny Committee.

The report aimed to understand, assess and give consideration to the Continuing Health Care (CHC) framework and how it was applied locally.  A Task & Finish Group had been set up to, amongst other things; evaluate the impact of CHC on clients and their families, focussing on both the process and the funding outcomes.

The Adult Care and Health Overview and Scrutiny Committee had considered the Scrutiny Review on Continuing Health Care report and its recommendations at its meeting on 27 June, 2018 and referred them to the Cabinet.  The Overview and Scrutiny Committee’s Minute was also provided for the Cabinet’s consideration.

The Cabinet noted the Task and Finish Group’s findings and that it had made seven recommendations as follows:

  “Recommendation 1 – Consistency of Application of the CHC Framework by Training

Members recognise that Wirral Clinical Commissioning Group (CCG) is not responsible for the staff training of other organisations. However, the CCG and all relevant health partners are requested to collaborate to ensure that all applicable staff receive the appropriate CHC training, where possible through joint sessions. This will enable frontline staff to pass on correct information to patients and families while operating with confidence to apply both the national CHC framework and local procedures. This should ensure that there is more consistency in the application of the framework. 

Recommendation 2 – Communication

Wirral Clinical Commissioning Group is requested to consider options to improve communication processes between themselves and partner organisations involved in the local delivery of the CHC framework (such as, Wirral Borough Council, Wirral Community Trust, Wirral University Teaching Hospital and GPs). Similarly, it is suggested that communication processes with potential applicants for CHC funding be reviewed and strengthened. 

Recommendation 3 – Dynamic Purchasing System (DPS)

Members note with concern that the introduction of the Dynamic Purchasing System (DPS) has resulted in some reduction of choice for clients while not realising the anticipated level of savings. As a result, Wirral CCG is requested to demonstrate to the Adult Care and Health Overview & Scrutiny Committee that continued use of DPS is providing value for money, is improving the efficiency of staff in identifying appropriate placements and is leading to an improved service for clients, particularly those requiring end of life care.

Recommendation 4 – End of Life Care

Wirral Clinical Commissioning Group is requested to ensure that those clients requesting CHC funding at end of life receive a service which is both compassionate and speedy. The allocation of placements to care homes who have successfully received the ‘Six Steps to Success End of Life Training Programme’ would be beneficial. 

Recommendation 5 – Learning Disabilities

Wirral Clinical Commissioning Group is requested to review the allocation of resources within the CHC team towards supporting those clients with learning disabilities through the CHC application process, ensuring the same access as people with physical needs.

Recommendation 6 – All-age Disabilities: Transition of Young People

As the delivery of the All-age Disability Strategy develops, members of the Adult Care and Health Overview & Scrutiny Committee are requested to consider the addition of a future review to their work programme, namely, to explore the experience of young people moving into adulthood. 

Recommendation 7 – Cost of Administration

The current cost of administering the Wirral CHC Service at £1m is a significant proportion of the overall cost of Wirral’s CHC budget. Wirral Clinical Commissioning Group is requested to consider whether any options are available to ensure that the administration of the CHC process can be achieved as cost effectively as possible”.

It was noted that the Committee had resolved as follows:

  “That

(1)  the report be noted and the findings and recommendations of the Continuing Healthcare Review Task and Finish Group be endorsed;

(2)  the indication of the Clinical Commissioning Group as to the development of an action plan arising from the findings of the Task and Finish Group be welcomed;

(3)  the members of the Continuing Healthcare Review Task and Finish Group be thanked for their work;

(4)  the report and recommendations of the Continuing Healthcare Review Task and Finish Group be forwarded to the Cabinet for their consideration.”

Councillor Chris Jones informed the Cabinet that the Task and Finish Group had carried out some good work and she welcomed Sue Wells, the Chair of the Clinical Commissioning Group’s action plan that she intended to present to the Joint Strategic Commissioning Group.

RESOLVED: That

(1)  the findings and recommendations of the Adult Care and Health Overview & Scrutiny Committee Task and Finish Group on the Continuing Healthcare Scrutiny Review as detailed above be endorsed;

(2)  the resolutions of the Adult Care and Health Overview and Scrutiny Committee as detailed above be endorsed;

(3)  the Cabinet’s thanks for the work carried out during the Review be also communicated to Members of the Continuing Healthcare Review Task and Finish Group.