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LORDS AMENDMENTS TO THE

COMMUNITY CARE (DELAYED DISCHARGES ETC.) BILL

[The page and line refer to HL Bill 20 as first printed for the Lords.]

Clause 1

1

Page 1, line 10, after “means” insert “, subject to subsection (2),”

2

Page 1, line 10, after “person” insert “other than a person receiving mental health

 

services”

3

Page 1, line 15, at end insert—

 

     “(2)       The term “qualifying hospital patient” does not include any person who is

 

ordinarily resident outside England and Wales.”

4

Page 1, line 15, at end insert—

 

     “(3)       An NHS body may make arrangements with any person connected with

 

the management of an independent hospital in the United Kingdom for

 

that person (or any employee of his) to do, on behalf of the NHS body and

 

in accordance with the arrangements, anything which is required or

 

authorised to be done by the NHS body by or under this Part in relation to

 

qualifying hospital patients accommodated in that hospital.

 

     (4)       Anything done or omitted to be done by or in relation to the authorised

 

person (or any employee of his) in pursuance of such arrangements is to be

 

treated as done or omitted to be done by or in relation to the NHS body.

 

     (5)       Nothing in subsection (3) or (4) prevents anything being done by or in

 

relation to the NHS body.”

Clause 2

5

Page 2, line 5, after “hospital” insert “after 1st April 2004”

6

Page 2, line 8, at end insert—

 

                  “and

 

                  (ii)                    has consulted with the patient (and in the case of a carer in

 

relation to assessment under the Carers (Recognition and

 

Services) Act 1995 (c. 12) and the Carers and Disabled

 

Children Act 2000 (c. 16)) to ascertain their views and

 

preferences, informed them of the reason for the

 
Bill 7653/2
 

 

    (  2  )

 
 

notification, and obtained their informed consent or in the

 

case where a patient lacks the mental capacity to give such

 

consent, has recorded on the file what steps have been taken

 

to ensure that the patient’s best interests have been duly

 

considered”

7

Page 2, line 10, after first “to” insert “(a)”

8

Page 2, line 12, at end insert “or

 

           “(b)              if it appears to them that the patient has no settled residence, to the

 

social services authority in whose area the hospital is situated”

9

Page 2, line 17, at end insert—

 

     “( )       Before giving a notice under this section the responsible NHS body must

 

consult—

 

           (a)           the patient; and

 

           (b)           if the responsible NHS body is aware of the identity of a person who

 

is a carer in respect of the patient and it is reasonably practicable to

 

consult him, that carer.”

10

Page 2, line 18, leave out subsection (4)

After Clause 2

11

Insert the following new Clause—

 

“Notices under section 2: supplementary

 

     (1)    A notice under section 2 remains in force until the patient to which it relates

 

is discharged, unless it has previously ceased to have effect by virtue of

 

subsection (2) or (3).

 

     (2)    The responsible NHS body may withdraw the notice by giving notice of

 

withdrawal to the responsible authority.

 

     (3)    Regulations may prescribe other circumstances in which the notice ceases

 

to have effect.

 

     (4)    If the notice ceases to have effect before the patient is discharged—

 

           (a)           no further steps under section 3, (Duties of responsible NHS body

 

following notice under section 2), or 4 resulting from the notice shall

 

be taken and no liability (or further liability) to make a payment

 

under section 4(4) shall accrue; and

 

           (b)           the responsible NHS body may (subject to section 2(1)) give a fresh

 

notice under section 2 in relation to the patient;

 

            but paragraph (a) does not affect any liability which accrues before the

 

notice ceases to have effect.

 

     (5)    Regulations may provide for—

 

           (a)           the form and content of—

 

                  (i)                 notices under section 2; and

 

                  (ii)                notices of withdrawal under subsection (2),

 

                         and the manner in which such notices are to be given;

 

           (b)           circumstances in which notices under section 2 must be withdrawn;

 

and

 
Bill 7653/2
 

 

    (  3  )

 
 

           (c)           determining the day on which a notice under section 2 or a notice

 

of withdrawal under subsection (2) is given (including provision

 

prescribing circumstances in which a notice under section 2 is to be

 

treated for any specified purpose as having been given on a day

 

other than that on which it was in fact given).”

Clause 3

12

Page 2, line 33, leave out from “case” to end of line 34 and insert “under section 2

 

has been given”

13

Page 2, line 35, leave out subsection (2)

14

Page 2, line 41, after “consulting” insert “the patient and having obtained the

 

informed consent of the patient or, in the case where a patient lacks the mental

 

capacity to give such consent to the proposed care plan, having recorded on the file

 

what steps have been taken to ensure that the patient’s best interests have been

 

duly considered, and after consulting”

15

Page 2, line 41, after “body” insert “and the qualifying patient”

16

Page 2, line 42, at end insert—

 

     “( )       Before making a decision under subsection (3), the responsible authority

 

must—

 

           (a)           consult the patient and his carer, if he has one;

 

           (b)           inform them of the cost of the proposed care plans; and

 

           (c)           obtain the consent of the patient and any carer and, where informed

 

consent is given, record that on the patient’s file, or if a patient lacks

 

the mental capacity to give such consent, record on the file what

 

steps it has taken to ensure that the patient’s best interests have

 

been duly considered.”

17

Page 3, line 1, leave out from “person” to end of line 2 and insert “who is a carer in

 

respect of”

18

Page 3, line 8, after “consulting” insert “the carer and obtaining the informed

 

consent of the carer to the proposed care plan and after consulting”

19

Page 3, line 10, leave out from “carer” to end of line 12

20

Page 3, line 21, at end insert—

 

     “(6A)       The responsible authority must keep under review—

 

           (a)           the needs of the patient; and

 

           (b)           the needs of any carer whose needs it has assessed under subsection

 

(4)(a),

 

            so far as affecting the services that need to be made available in order for it

 

to be safe to discharge the patient.

 

     (6B)       The responsible authority may, after consulting the responsible NHS body,

 

alter—

 

           (a)           its decision under subsection (3)(b); or

 

           (b)            any decision taken by it under subsection (4)(b),

 
Bill 7653/2
 

 

    (  4  )

 
 

            to take account of any change in circumstances since the assessment carried

 

out under subsection (3)(a) or (4)(a) (as the case may be).

 

     (6C)       The responsible authority must inform the responsible NHS body of the

 

decision under subsection (3)(a), of any decision under subsection (4)(a)

 

and of any alteration made under subsection (6B).”

21

Page 3, line 22, leave out subsection (7)

22

Page 3, line 26, leave out subsections (8) to (10)

23

Page 3, line 37, at end insert—

 

     “( )       The responsible NHS body must give the patient and his carer, if he has

 

one—

 

           (a)           notice of the day on which it proposes to discharge the patient, and

 

where informed consent is given, record that on the patient’s file, or

 

if a patient lacks the mental capacity to give such consent, record on

 

the file what steps it has taken to ensure that the patient’s best

 

interests have been duly considered, and

 

           (b)           information about their right to request a review if they disagree

 

with the decision to discharge.”

24

Page 3, line 45, at end insert—

 

     “( )       The Secretary of State shall specify to the bodies charged with inspection of

 

health and social services that they should monitor, at regular intervals, the

 

impact of this Act on patients and their carers.”

25

Page 3, line 45, at end insert—

 

     “( )       The Secretary of State shall report on an annual basis to Parliament on the

 

outcomes of patients affected by this Act.”

After Clause 3

26

Insert the following new Clause—

 

“ Duties of responsible NHS body following notice under section 2

 

     (1)    The duties under this section apply where notice of a patient’s case under

 

section 2 has been given.

 

     (2)    The responsible NHS body, and any other NHS body which is considering

 

whether to provide services to the patient after discharge, must consult the

 
Bill 7653/2
 

 

    (  5  )

 
 

responsible authority before deciding what services (if any) it will make

 

available to him in order for it to be safe to discharge the patient.

 

     (3)    The responsible NHS body must give the responsible authority notice of

 

the day on which it proposes to discharge the patient.

 

     (4)    The notice under subsection (3) remains in force until the end of the

 

relevant day, unless it has previously been withdrawn.

 

     (5)    The responsible NHS body may withdraw the notice under subsection (3)

 

at any time before the end of the relevant day by giving notice of

 

withdrawal to the responsible authority.

 

     (6)    For the purposes of this Part “the relevant day”, in relation to a qualifying

 

hospital patient, is the later of—

 

           (a)           the day specified in the notice under subsection (3); and

 

           (b)           the last day of the prescribed minimum interval after the notice

 

under section 2 is given.

 

     (7)    Regulations may prescribe a period as the minimum interval after a notice

 

under section 2 is given; but that period must—

 

           (a)           begin with the day after that on which the notice under section 2 is

 

given; and

 

           (b)           be a period of at least two days excluding Saturdays, Sundays and

 

public holidays.

 

     (8)    If the notice under subsection (3) is withdrawn before the end of the

 

relevant day—

 

           (a)           the duty under subsection (3) applies again; and

 

           (b)           when a fresh notice under subsection (3) is given, subsection (6)

 

applies again for the purpose of identifying a new “relevant day”.

 

     (9)    Regulations may provide for—

 

           (a)           the time at which notices under subsection (3) are to be given;

 

           (b)           the form and content of—

 

                  (i)                 notices under subsection (3); and

 

                  (ii)                withdrawal notices under subsection (5);

 

                         and the manner in which such notices are to be given;

 

           (c)           circumstances in which notices under subsection (3) must be

 

withdrawn; and

 

           (d)           determining the day on which a notice under subsection (3) or a

 

notice of withdrawal under subsection (5) is given (including

 

provision prescribing circumstances in which a notice under

 

subsection (3) is to be treated for any specified purpose as having

 

been given on a day other than that on which it was in fact given).”

Clause 4

27

Page 4, line 3, leave out subsection (1) and insert—

 

     “(1)       This section applies where notice of a patient’s case under section 2 and

 

notice of the proposed discharge day under section (Duties of responsible

 

authority after notice under section 2)(3) have both been given (and are in

 

force).”

28

Page 4, line 8, leave out subsections (2) and (3)

 
Bill 7653/2
 

 
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