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Amendments to the Community Care (Delayed Discharges etc.) Bill

Community Care (Delayed Discharges etc.) Bill


AMENDMENTS
TO BE MOVED
IN COMMITTEE


 

Clause 1

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 1, line 9, leave out "and" and insert "or
(c)  a Care Trust within the meaning of section 45 of the Health and Social Care Act 2001 (c. 15) (care trusts); and"
Page 1, line 14, leave out "care of a description prescribed in regulations" and insert "geriatric, acute care"
Page 1, line 15, at end insert "or in furtherance of a pilot scheme"
Page 1, line 15, at end insert "except where the patient is accommodated in an independent hospice or an NHS palliative care unit"
 

Clause 2

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 2, line 6, after "the" insert "responsible body and the"
Page 2, line 6, after "body" insert "and the responsible authority"
 

THE BARONESS BARKER
THE BARONESS MADDOCK

Page 2, line 11, after second "the" insert "Primary Care Trust, Housing and"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 2, line 14, at end insert—
"(   )  must contain a written discharge plan, including an assessment of community needs within the meaning of section 47 of the National Health Service and Community Care Act 1990 (c. 19) (assessment of needs for community care services), and arrangements for aftercare;
(   )  where the patient has an intending carer, within the meaning of section 1(1)(b) of the Carers (Recognition and Services) Act 1995 (c. 12) (assessment of ability of carers to provide care: England and Wales), an assessment in compliance with section 1 of that Act."
Page 2, line 18, at end insert—
"(   )  the form of a written discharge plan;"
 

Clause 3

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 2, line 36, at end insert ", subject to subsection (3) below"
Page 2, line 37, leave out subsection (3) and insert—
"(3)  The responsible NHS body and the responsible authority shall—
(a)  carry out a joint assessment of the patient's needs with a view to identifying those health and community care services that need to be made available in order for it to be safe to discharge him; and
(b)  agree which of those patients (if any) the authority will make available for the patient."
Page 2, line 38, after "assessment" insert "under the single assessment process"
Page 2, line 39, after "services" insert "or community health services"
Page 2, line 42, at end insert "; and
(c)  inform any person where it appears to them that they may be entitled under section (1) of the Carers (Recognition and Services) Act 1995 (c. 12) (assessment of ability of carers to provide care: England and Wales) and section (1) of the Carers and Disabled Children Act 2000 (c. 16) (right of carers to assessment) to request an assessment of their ability to provide and continue to provide care."
Page 3, line 1, leave out from second "of" to "with" in line 3 and insert "anyone acting as the patient's carer"
Page 3, line 24, leave out "may" and insert "shall"
Page 3, line 30, leave out "must give the responsible authority notice of" and insert "and the responsible authority shall agree"
Page 3, line 31, leave out "proposes" and insert "is proposed"
 

Clause 4

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 4, line 8, leave out subsections (2) and (3) and insert—
"(   )  The responsible NHS body and the responsible authority shall, in the case of each patient where a discharge notice under section 3(7) has been issued, agree—
(a)  a definite day of discharge (the "relevant day");
(b)  a joint aftercare plan for the provision of relevant health and community care services following the day of discharge for an agreed period."
Page 4, line 15, at end insert "excluding bank holidays and weekends"
Page 4, line 23, at end insert—
"(   )  No such payments shall be made where the reason for the delayed discharge is not the responsibility of the responsible authority."
Page 5, line 13, at end insert "and spent according to an agreement drawn up locally"
Page 5, line 14, leave out subsection (10)
 

After Clause 4

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Insert the following new Clause—
  "Pilot schemes
  The Secretary of State or the Assembly may by order establish pilot schemes for the operation of this Part in selected areas."
 

Clause 6

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 5, line 28, leave out subsection (1) and insert—
"(   )  The responsible NHS body and the responsible local authority shall set up an independent panel to hear the complaints of patients or their carers, or both, where they—
(a)  disagree with the decision of the NHS that the patient should be discharged from NHS care, or with the type or quantity of NHS care to be delivered; or
(b)  disagree with the community care services proposed by social services for a safe discharge.
(   )  The independent panel must complete its review of the case within two weeks, having sought appropriate advice from professionals who know the patient or the carer, or both, and independent clinical advice where this is deemed necessary; and considered the evidence of the patient or carer or both, or other representative of the patient, and during this time the patient should remain under the care of the NHS, and the decision of the panel will be binding.
(   )  The relevant social services department shall provide a fast track complaints system for people who, within 8 weeks of discharge from hospital, feel that the support provided is inadequate to their needs."
Page 5, line 29, after "Wales" insert "in agreement with their local authority counterparts"
Leave out Clause 6 and insert the following new Clause—
  "Joint local protocols and dispute resolution
(1)  In each social services authority area, the responsible NHS bodies and the responsible authority shall agree a joint local protocol regarding the discharge of qualifying hospital patients.
(2)  Each joint local protocol shall contain—
(a)  an action plan designed to prevent delayed discharges before they occur;
(b)  local targets for reducing delayed discharges;
(c)  joint administrative arrangements for the local implementation of the duties in Sections 2, 3 and 4 in this Act; and
(d)  an agreement on how monies made in payment under Section 4 of this Act shall be spent for the purpose of reducing delays in discharging qualifying hospital patients in the future.
(3)  In each social services authority area, the responsible NHS bodies and the responsible authority shall create a panel to assist in the resolution of disputes under this Part between the responsible NHS bodies and the responsible authority.
(4)  The panel shall be jointly appointed by the responsible NHS bodies and the responsible authority, and its members shall have experience or knowledge of local health and community care services or local circumstances, but shall not be current employees or members of any NHS or local authority body.
(5)  The panel shall have the power to adjudicate on any matter in dispute under this Part referred to it by any of the parties to the dispute and its decisions shall be binding on the responsible NHS bodies and the responsible authority.
(6)  Any NHS body or social services authority shall be prohibited from bringing legal proceedings against another such body in relation to a dispute under this Part before such steps have been taken in relation to a panel established by virtue of this section."
 

Clause 7

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 5, line 21, leave out subsection (2)
 

Clause 8

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 6, line 24, at end insert "by statutory instrument and no such statutory instrument shall be made unless a draft of the instrument has been laid before and approved by resolution of each House of Parliament"
Page 6, line 30, leave out from "State" to "to" in line 31
 

Clause 9

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 6, line 34, at end insert—
 "`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 (within the meaning of the National Assistance Act 1948 (c. 29));"
Page 6, line 41, at end insert—
 "`pilot scheme' shall mean a pilot scheme conducted under Clause (Pilot schemes) above"
Page 6, line 43, at end insert "and may include a housing authority as well as a social services authority where relevant"
 

Clause 12

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 8, line 6, at end insert—
  "and that local authorities are not to charge for social care; if that social care is—
(a)  personal care defined in section 121(9) of the Care Standards Act 2000 (c. 14) as assistance in connection with bodily functions;
(b)  nursing care, whether or not from a registered nurse; or
(c)  the care of a kind mentioned in Schedule (Social care not ordinarily charged for)."
Page 8, line 6, at end insert—
  "and that the local authorities are not to charge for care provided by them of a kind for the time being mentioned in Schedule (Social care not ordinarily charged for (No. 2)) to this Act; or for nursing care, whether or not from a registered nurse"
 

Clause 17

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 9, line 40, at end insert—
"(2A)  Part 1 shall only come into effect following publication of an evaluation by the Audit Commission of a pilot scheme conducted under section (Pilot schemes) above.
(2B)  The publication of the evaluation under subsection (2A) above shall not take place earlier than 1st April 2004."
 

Schedule

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Insert the following new Schedule—
 

"SCHEDULE
SOCIAL CARE NOT ORDINARILY CHARGED FOR

 1      With regard to the personal hygiene of the person cared for—
(a)  shaving;
(b)  cleaning teeth and providing assistance in rinsing the mouth;
(c)  keeping finger nails and toe nails trimmed;
(d)  assisting the person with going to the toilet or with using a bedpan or other receptacle;
(e)  where the person is fitted with a catheter or stoma, providing such assistance as is required to ensure cleanliness and that the skin is kept in a hygienic condition;
(f)  where the person is incontinent—
(i)  the provision and changing of continence pads; and
(ii)  caring for the person's skin to ensure that it is not adversely affected.
 2      With regard to the person's eating requirements, assisting with the administration of food.
 3      If the person is immobile or substantially immobile, dealing with the problems caused by that immobility.
 4      If the person requires medical treatment, assisting with medication, as for example by—
(a)  applying creams, lotions; or administering eye drops;
(b)  applying dressings in cases where this can be done without the physical involvement of a registered nurse or of a medical practitioner.
 5      With regard to the person's general well-being—
(a)  assisting with getting dressed;
(b)  assisting with surgical appliances, prosthesis and mechanical and manual equipment;
(c)  assisting with getting up and with going to bed."

 
 
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©Parliamentary copyright 2003
3 February 2003