Agenda item

The Board considered a report of West Leicestershire Clinical Commissioning Group, a copy of which, marked ‘Agenda Item 9’, is filed with these minutes.  The Chairman made the decision to consider the report alongside the next item on the agenda for the meeting, the report of East Leicestershire and Rutland CCG on the Settings of Care Policy. A copy of that report, marked ‘Agenda Item 10’ is filed with these minutes. Both reports addressed the CCGs respective positions with regard to the Continuing Healthcare Settings of Care Policy.

The Chairman welcomed Caroline Trevithick, Chief Nurse and Deputy Managing Director at West Leicestershire Clinical Commissioning Group, and Carmel O’Brien, Chief Nurse & Quality Officer at East Leicestershire and Rutland CCG to the meeting for these items.

It was highlighted that amendments had been made to the version of the Settings of Care Policy appended to the report of East Leicestershire and Rutland CCG in the agenda pack as a result of their Board meeting on 11 July 2017. The latest version of the Policy would be circulated to Members after the meeting.

Arising from discussions the following points were noted:

(i)        The CCG Communications Team had formulated the project plan for carrying out the consultation on the Settings of Care Policy, and the Arden and Greater East Midlands Commissioning Support Unit had conducted the work. It was questioned whether the consultation documents had been sent to the Loughborough Echo newspaper and officers agreed to provide Members with a full list of the media outlets that had been included in the consultation. It was noted that although the consultation documents may have been sent to particular newspapers, individual newspapers could choose not to publish them, though this was unlikely. Members suggested that in future the CCGs should follow up with stakeholders who did not publicise consultations.

(ii)       It was noted that of the 1300 copies of the consultation document that had been sent out, 212 had been returned and it was clarified that the 212 comprised of a mix of those who were in receipt of Continuing Healthcare and people who were not. Members raised concerns that this was an insufficient number. Reassurance was given that legal advice had been sought on whether the extent of the consultation was adequate and the advice given was that all reasonable steps had been taken to publicise the proposed changes. In particular, the CCGs had written to every patient in receipt of Continuing Healthcare and had offered telephone interviews to these patients.

(iii)      Members questioned whether the impact of the Policy in terms of the numbers of people affected was fully understood. Clarification was given that if a patient’s clinical needs did not change then the policy that applied to them would not change. It was only if the patient’s condition deteriorated and their current setting of care was no longer clinically safe for their needs that the new policy would apply. It was not intended that the new policy would be financially driven; the CCGs would continue to provide high cost placements. Consequently, as it was difficult to predict how many patients would deteriorate and to what extent then it was difficult to be sure how many patients would be affected by the new policy. Nevertheless, conversations were continuing with all patients currently in receipt of Continuing Healthcare. The further work which the Governing Body of West Leicestershire Clinical Commissioning Group had requested be carried out regarding the impact of the Policy was about looking at the types of patients that would be affected rather than specific numbers.

RESOLVED:

(a)       That the update on progress with the West Leicestershire Clinical Commissioning Group Continuing Healthcare Settings of Care Policy be noted;

(b)       That the decision of West Leicestershire Clinical Commissioning Group to give further consideration to the impact of the potential change on patients, carers, and other health and care services caused by the new Policy be welcomed.

(c)       That the update on progress with the East Leicestershire and Rutland Clinical Commissioning Group Continuing Healthcare Settings of Care Policy be noted.