Amendment Paper as at
Wednesday 15th January 2003
CONSIDERATION OF BILL
COMMUNITY CARE (DELAYED DISCHARGES ETC.) BILL, AS AMENDED
NEW CLAUSES
Free provision of services in Wales
Mr Secretary Milburn
NC8
To move the following Clause:—
'The Assembly may by regulations made by statutory instrument make in relation to local authorities in Wales any provision which may be made by the Secretary of State under section 12 in relation to local authorities in England.'.
Personal care
Mr Paul Burstow
Mrs Patsy Calton
NC1
To move the following Clause:—
'Local authorities are not to charge for care, if that care is—
| (a) | personal care defined in section 121(9) of the Care Standards Act 2000 as assistance in connection with bodily functions; |
| (b) | nursing care, whether or not from a registered nurse.'. |
Piloting of Part 1
Mr Paul Burstow
Mrs Patsy Calton
NC2
To move the following Clause:—
'(1) Part 1 may only come into effect subject to evaluation by the Audit Commission of pilot schemes under subsection 3.
(2) The Secretary of State or Assembly for Wales shall by order, elect pilot schemes in selected areas after consultation with the Commission for Health Improvement or any successor bodies.
(3) Part 1 shall not come into effect before April 2004, and subject to subsection 2 above the appropriate Minister may by order on such a day appoint that Part 1 come into force; and different days may be appointed for different purposes.'.
Meaning of 'carer' and 'carers' assessment'
Mr Paul Burstow
Mrs Patsy Calton
NC3
To move the following Clause:—
'(1) In this Part "carer", in relation to a qualifying hospital patient, means a person aged over 16 who—
| (a) | provided (prior to admission in hospital) or intends to provide a substantial amount of care to the qualifying hospital patient on a regular basis once they are discharged, and |
| (b) | did not or will not provide this care— |
| (i) | by virtue of a contract of employment or other contract with any person, or |
| (ii) | as a volunteer for a voluntary organisation. |
(2) In subsection (1), "voluntary organisation" has the same meaning as in the National Assistance Act 1948.
(3) The responsible authority shall inform any person where it appears to them that they may be entitled under section (1) of the Carers (Recognition and Services) Act 1995 and section (1) of the Carers and Disabled Children Act 2000 to request an assessment of their ability to provide and continue to provide care.
(4) The assessment of the patient's needs under section (3)(3)(a) must take account of the results of any assessment undertaken of the carer's ability to provide and continue to provide care for the patient under the Carers (Recognition and Services) Act 1995 or the Carers and Disabled Children Act 2000 or both those Acts.'.
Definition of delayed discharge
Mr Paul Burstow
Mrs Patsy Calton
NC4
To move the following Clause:—
'In this Part "delayed discharge" shall be taken to mean a delay in transfer occurring when a patient is ready for transfer from a general and acute hospital bed to another care setting, but is still occupying such a bed; and a patient is ready for transfer when a clinical recommendation has been made that the patient is ready for transfer subject to a single assessment process and a multi-disciplinary team decision has been made that the patient is ready for, and safe to, discharge or transfer to another care setting.'.
Action plans and joint local protocols
Mr Paul Burstow
Mrs Patsy Calton
NC5
To move the following Clause:—
'.—(1) The responsible NHS body and responsible authority are required to agree the following as regards the discharge of qualifying hospital patients as defined in section 1 of this Act—
| (a) | action plans to prevent and reduce delayed discharges; |
| (b) | joint local protocols on the administrative and practical arrangements for the implementation of the legislation to ensure that all parties are clear about their respective roles and responsibilities; |
| (c) | local targets for reducing delayed discharges; |
| (d) | joint administrative arrangements for the local implementation of the duties in sections 2, 3 4 and 5 in this Act. |
(2) An action plan under subsection (1) above is a document drawn up by the relevant bodies specifying action intended to reduce delayed discharges, and to change procedures and arrangements which may cause or contribute to the failure to comply with duties under section 3.
(3) Joint local protocols will include named persons responsible for co-ordinating all stages of the patient journey up to and beyond discharge, and ensuring that all necessary arrangements are put in place at the right time.
(4) Local protocols may include joint agreement on how payments made under section 4 are used to encourage a whole system approach to services for older people, and to ensure that all stakeholders are involved in deciding how the payments are spent.'.
Written discharge plan
Mr Paul Burstow
Mrs Patsy Calton
NC6
To move the following Clause:—
'.—(1) Further to the fulfilment of the requirements under section 3(3)(a) and (b) a written discharge plan shall be produced and taken to include—
| (a) | an assessment of community needs within the meaning of section 47 of the National Health Service and Community Care Act 1990, and arrangements for aftercare; and |
| (b) | where the patient has an intending carer, within the meaning of section 1(1)(b) of the Carers (Recognition and Services) Act 1995, an assessment in compliance with section 1 of that Act. |
(2) Regulations may prescribe the form of a written discharge plan.'.
Single assessment process
Mr Paul Burstow
Mrs Patsy Calton
NC7
To move the following Clause:—
'( ) Further to the fulfilment of the requirements under section 2(1)(a) and (b) a single assessment process shall be undertaken to include—
| (a) | assessment of entitlement for continuing care in pursuance of statutory responsibilities under the National Health Service Act 1977; |
| (b) | assessment of entitlement to NHS funded nursing care pursuant to section 49 of the Health and Social Care Act 2001; |
| (c) | assessment of the local authorities' duties under section 47(1) of the National Health Service and Community Care Act 1990; |
| (d) | a joint "aftercare plan" for the provision of relevant health and community care services following the day of discharge for an agreed period, including ensuring that GPs receive written "discharge summaries" promptly so that they are aware of their patient's needs in the community; |
| (e) | a single information-gathering process regarding the patient's needs, no matter that the assessment and subsequent care planning and service delivery involves a number of professionals and agencies, whereby each patient is informed of, and consents to, information about their needs and circumstances being collected and shared, and with key decisions and issues to be copied in writing, or other appropriate formats, to the older person; |
| (f) | a duty on the professionals undertaking the assessment to work together in the best interests of the older person, as defined by the older person or those close to them; |
| (h) | consideration of the older person's views and wishes and external or environmental factors that are causing or exacerbating needs, including not only health and social care issues but also relevant housing, benefits, transport and other issues, the depth and detail of the assessment to be proportionate to an individual's needs; |
| (i) | the results of any assessment undertaken of the carer's ability to provide and continue to provide care for patient under the Carers (Recognition and Services) Act 1995 or the Carers and Disabled Children Act 2000 or both those Acts.'. |
Carers: duties
Mr Paul Burstow
Mrs Patsy Calton
NC9
To move the following Clause:—
'(1) Further to fulfilment of the requirements under section 2(2) and (3) it shall the duty of the responsible authority to—
| (a) | inform any person where it appears to them that they may be entitled under section (1) of the Carers (Recognition and Services) Act 1995 and section (1) of the Carers and Disabled Children Act 2000 to request an assessment of their ability to provide and continue to provide care; |
| (b) | ensure that the assessment carried out under the above provisions provide sufficient information in the care plan, or to make arrangements that a provider of services to the patient can carry out an appropriate assessment, to satisfy Standards 3 and 4 of the National Minimum Care Standards for Care Homes and Standards 2 and 3 of the Draft National Minimum Care Standards for Domiciliary Care, as required by the Care Standards Act 2000. |
(2) Where, for the purposes of satisfying the fitness for purpose of proposed accommodation under the Care Standards Act 2000, the assessment procedure exceeds three days, the delayed discharge period shall be disapplied.'.
Mr Alan Simpson
Sir Sydney Chapman
Mr Brian Iddon
Dr David Chaytor
Valerie Davey
Mrs Helen Clark
'"community care services" includes services to provide home warmth hereinafter referred to as "affordable warmth services".'.
