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

Community Care (Delayed Discharges etc.) Bill


MARSHALLED
LIST OF AMENDMENTS
TO BE MOVED
IN COMMITTEE


[Amendments marked * are new or have been altered]

Amendment
No.

 

Clause 1

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES
THE BARONESS FINLAY OF LLANDAFF

1Page 1, line 5, at end insert—
 ""delayed discharge" means a delay in transfer occurring when—
(a)  the patient is eligible for discharge from a general and acute hospital bed to another care setting, subject to a single assessment process; and
(b)  a multi-disciplinary team decision has been made that the patient is ready for, and safe to, discharge or transfer to another care setting, but the patient is still occupying such a bed;
 "eligible for discharge" means judged fit for discharge in accordance with—
(a)  a clinical recommendation; and
(b)  discharge procedures adopted by NHS trusts in accordance with guidance issued by the Secretary of State or the Assembly;"
2Page 1, line 9, after "Wales);" insert "or
(c)  a Care Trust within the meaning of section 45 of the Health and Social Care Act 2001 (c. 15) (care trusts);"
 

THE LORD HUNT OF KINGS HEATH

3*Page 1, line 10, after "means" insert ", subject to subsection (2),"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

4Page 1, line 12, after "hospital" insert "or hospice"
 

THE EARL HOWE
THE BARONESS NOAKES

5Page 1, line 14, after "receive)" insert "geriatric or acute"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

6Page 1, line 14, leave out "care of a description prescribed in regulations" and insert "geriatric acute care"
7Page 1, line 15, at end insert "or in furtherance of a pilot scheme"
8Page 1, line 15, at end insert "which shall specify the circumstances in which a patient is or may become regarded as a self funder"
9*Page 1, line 15, at end insert "other than a user of mental health services"
 

THE LORD HUNT OF KINGS HEATH

10*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."
 

THE EARL HOWE
THE BARONESS NOAKES

11Page 1, line 15, at end insert—
"(   )  Regulations shall not extend the description of care to include NHS mental health services."
 

Clause 2

 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER
THE BARONESS FINLAY OF LLANDAFF

12Page 2, line 5, after "hospital" insert "after 1st April 2004"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

13Page 2, line 6, after "the" insert "responsible body and the"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

14Page 2, line 6, leave out "considers" and insert "and the responsible authority consider"
 

THE BARONESS BARKER
THE BARONESS MADDOCK

15*Page 2, line 8, after "services" insert "which may include affordable warmth services"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

16Page 2, line 8, at end insert—
"(   )  the responsible NHS body and the social services authority publish and operate an agreed code of practice governing the sharing of patient information;
(   )  in cases where a patient has limited mental capacity, a procedure exists to appoint an independent advocate."
17Page 2, line 9, after first "of" insert "a named Discharge Officer acting on behalf of"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES
THE BARONESS FINLAY OF LLANDAFF

18Page 2, line 9, after "body" insert "having obtained the consent of the patient and, where appropriate, his carer"
 

THE LORD HUNT OF KINGS HEATH

19*Page 2, line 10, after first "to" insert "(a)"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

20Page 2, line 10, leave out from "authority" to "in" in line 11
 

THE LORD HUNT OF KINGS HEATH

21*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"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

22Page 2, line 12, at end insert—
"(   )  Before giving the notice referred to in subsection (2) above, the responsible NHS body shall consult the patient and his carers, if he has any, in order to ascertain their views and preferences, 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."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

23*Page 2, line 12, at end insert—
"(2A)  Further to the fulfilment of the requirements under subsection (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 (c. 49);
(b)  assessment of entitlement to NHS funded nursing care pursuant to section 49 of the Health and Social Care Act 2001 (c. 15) (nursing care);
(c)  assessment of the local authorities' duties under section 47(1) of the National Health Service and Community Care Act 1990 (c. 19) (assessment of needs for community care services);
(d)  consideration of the patient's views and wishes;
(e)  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 (c. 12) or the Carers and Disabled Children Act 2000 (c. 16), or both."
24*Page 2, line 12, at end insert—
"(2A)  Where the patient is unable to understand the terms of the notice, the responsible NHS body shall, before issuing the notice, consult—
(a)  a person appointed by the entitled person to be his advocate,
(b)  his nearest relative as defined in section 29 of the Mental Health Act 1983,
(c)  his receiver appointed under Part VII of the Mental Health Act 1983,
(d)  his attorney or attorneys appointed in accordance with the Enduring Powers of Attorney Act 1985, or
(e)  any person who accrues such rights under successor legislation."
25Page 2, line 13, at end insert "which must be in writing"
26Page 2, line 17, at end insert—
"(   )  must state the name and job title of the person giving the notice on behalf of the responsible NHS body"
27Page 2, line 19, after first "the" insert "written"
28Page 2, line 22, at end insert—
"(   )  the days of the week and public holidays on which such notices may or may not be given"
29Page 2, line 22, at end insert—
"(   )  the written form in which notices may be withdrawn"
 

THE BARONESS FINLAY OF LLANDAFF

30Page 2, line 28, at end insert "; or
(c)  if the hospice concerned has arrangements for NHS patients, the hospice management authority"
 

THE BARONESS BARKER
THE BARONESS MADDOCK

31Page 2, line 31, after "services" insert "or housing"
 

Clause 3

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

32Page 2, line 36, at end insert ", subject to subsection (3) below"
33Page 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 services (if any) the authority will make available for the patient."
34Page 2, line 37, at end insert "with the consent of the patient"
35Page 2, line 38, after "an" insert "initial"
36Page 2, line 38, after "assessment" insert "under the single assessment process"
37Page 2, line 39, after "services" insert "or community health services"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

38Page 2, line 39, after "services" insert "or community health services (or both)"
39Page 2, line 41, after "body" insert "or hospice management authority"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

40Page 2, line 42, leave out "make available" and insert "commission"
41Page 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."
 

THE BARONESS BARKER
THE LORD BRADSHAW

42*Page 2, line 42, at end insert "; and
(c)  ensure that the assessment carried out under the provisions in paragraphs (a) and (b) provides sufficient information in the care plan, or makes arrangements for a provider of services to the patient to 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 (c. 14).
(3A)  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 calculation of the delayed discharge period shall not include those days."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

43Page 2, line 42, at end insert "; and
(c)  have a written discharge plan, including an undertaking that 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) will continue according to patient needs, 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) or section 1 of the Carers and Disabled Children's Act 2000, an assessment and a written plan of support services will be provided."
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

44Page 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."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

45*Page 2, line 42, at end insert—
"(3A)  For the purposes of subsection (3), an assessment means a full multidisciplinary assessment of the patient's needs and entitlement to services under—
(a)  section 47(1) of the National Health Service and Community Care Act 1990 (c. 19) (assessment of needs for Community Care Services),
(b)  the Health and Social Services and Public Health Act 1968,
(c)  the Chronically Sick and Disabled Persons Act 1970,
(d)  the National Health Services Act 1977 (c. 49),
(e)  the Mental Health Act 1983,
(f)  section 47(3) of the Disabled Persons (Services, Consultation and Representation) Act 1986, and
(g)  section 49 of the Health and Social Care Act 2001 (c. 15) (nursing care)."
46Page 2, line 44, after "(5)," insert "having informed the carer of his right to an assessment under section 2 of the Carers and Disabled Children Act 2000 (c. 16) (services for carers),"
47Page 3, line 1, leave out from second "of" to "with" in line 3 and insert "anyone acting as the patient's carer"
48Page 3, line 6, leave out "made available to" and insert "commissioned for"
49Page 3, line 9, leave out "make available to" and insert "commission for"
50Page 3, line 10, at end insert "(and having been so informed by the responsible authority)"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

51Page 3, line 18, at end insert—
"(   )  The responsible NHS body and the responsible authority must take all reasonable steps to ensure that carers covered by subsection (5) above are aware of their rights to have their needs assessed under subsection (4)."
52Page 3, line 22, after "body" insert "or responsible authority"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

53Page 3, line 22, after "body" insert "or hospice"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

54Page 3, line 24, leave out "may" and insert "shall"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

55Page 3, line 24, leave out "may" and insert "or hospice shall"
56Page 3, line 26, after first "body" insert "or hospice"
 

THE EARL HOWE
THE BARONESS NOAKES
THE LORD CLEMENT-JONES

57Page 3, line 26, leave out from first "body" to "provide" in line 27 and insert "must consider whether it or any other NHS body should"
58Page 3, line 27, leave out "must consult" and insert "and must—
(a)  provide information about the patient to any other NHS body that the responsible NHS body considers should provide services to the patient; and
(b)  consult and agree with"
59Page 3, line 29, at end insert—
"(   )  The responsible NHS body must take into account the views of the patient's carer, if he has one, before deciding what services (if any) it will make available following discharge."
60Page 3, line 29, at end insert—
"(   )  The responsible NHS body must, before deciding what services (if any) it will make available following discharge, consult 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."
 

THE BARONESS FINLAY OF LLANDAFF
THE LORD CLEMENT-JONES

61Page 3, line 29, at end insert—
"(   )  The responsible NHS body must ensure that the carer (or carers) providing any part of the patient's care as outlined in the discharge plan are assessed for and, as needed, instructed in safe lifting and handling techniques before the discharge notice becomes valid."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

62Page 3, line 30, leave out "must give the responsible authority notice of" and insert "and the responsible authority shall agree"
63Page 3, line 31, leave out "proposes" and insert "is proposed"
 

THE EARL HOWE
THE BARONESS NOAKES
THE LORD CLEMENT-JONES

64Page 3, line 31, at end insert "and must compensate it for any expenses which it incurs if the responsible NHS body fails to discharge the patient on that day"
65Page 3, line 31, 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."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

66Page 3, line 32, at end insert—
"(   )  the form of a written discharge plan;"
 

THE EARL HOWE
THE BARONESS NOAKES
THE LORD CLEMENT-JONES

67Page 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."
68Page 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."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

69Page 3, line 45, at end insert—
"(   )  Section 60 of the Health and Social Care Act 2001 (c. 15) (control of patient information) shall not apply to personal data collected for the purposes of assessments and consultations carried out under this section."
70Page 3, line 45, at end insert—
"(   )  Anything done under subsections (3) and (4) must be subject to review under the single assessment procedure no later than 42 days after the relevant day determined under section 4(4)."

 
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©Parliamentary copyright 2003
14 February 2003