Community Care (Delayed Discharges etc.) Bill—
Amendments to be debated in the House of Lordscontinued

House of Lords

back to previous amendments

 

After Clause 3

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

71Insert the following new Clause—
  "Action plans and joint local protocols
(1)  The responsible NHS body and responsible authority are required to agree the following as regards the discharge of qualifying hospital patients 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 defining the roles and responsibilities of all parties;
(c)  local targets for reducing delayed discharges;
(d)  joint administrative arrangements for the local implementation of the duties in sections 2 to 5.
(2)  An action plan under this section 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 will include joint agreement on how payments made under section 4 are used to encourage a whole systems approach to services for older people, and to ensure that all stakeholders are involved in deciding how the payments are spent."
 

Before Clause 4

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

72Insert the following new Clause—
  "Assessment of needs
(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 (c. 19) (assessment of needs for community care services), 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 (c. 12) (assessment of ability of carers to provide care: England and Wales), an assessment in compliance with section 1 of that Act.
(2)  Regulations may prescribe the form of a written discharge plan."
 

Clause 4

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

73Page 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."
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS WILKINS

74Page 4, line 15, leave out "two days" and insert "three working days, excluding Saturdays, Sundays, bank holidays and public holidays"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

75Page 4, line 15, at end insert—
  "excluding bank holidays and weekends"
76Page 4, line 15, at end insert—
  "except in cases where discharge is to a registered nursing home or residential home when the period shall be at least five days"
77Page 4, line 16, at beginning insert "Subject to subsection (4A),"
 

THE EARL HOWE
THE BARONESS NOAKES

78Page 4, line 19, leave out ", and only because,"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

79*Page 4, line 23, at end insert—
"(   )  No such payments shall be made where the delayed discharge does not result from any action or omission by the responsible authority."
 

THE BARONESS FINLAY OF LLANDAFF
THE LORD CLEMENT-JONES

80Page 4, line 23, at end insert—
"(   )  Subsection (4) shall not have effect where the delayed discharge is solely due to the non-arrival or delay in arrival of ambulance transport."
81Page 4, line 23, at end insert—
"(   )  Subsection (4) shall not have effect unless the responsible authority has been responsible for either—
(a)  one delayed discharge of more than two weeks, or
(b)  two delayed discharges of up to one week each,
  in the six month period preceding the relevant day in subsection (4)."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

82Page 4, line 23, at end insert—
"(4A)  The payment due under subsection (4) may be reduced (as prescribed in regulations) by up to 100 per cent where it has not been possible to discharge the patient because the responsible NHS body has been unable to make available a relevant health and community care service as agreed in the aftercare plan."
83Page 4, line 25, leave out "made available" and insert "commissioned"
84Page 4, line 28, leave out "made available" and insert "commissioned"
 

THE LORD HUNT OF KINGS HEATH

85*Page 4, line 29, leave out "provide" and insert "make available"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

86Page 4, line 35, after "body" insert "or hospice"
 

THE LORD HUNT OF KINGS HEATH

87*Page 4, line 38, at end insert "and
"(c)  every service that it decided under section 3(4)(b) to make available to a carer has been made available,"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

88Page 4, line 40, leave out subsection (8)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

89Page 5, line 11, leave out subsection (9) and insert—
"(   )  Any payment which a relevant NHS body or relevant social services authority is required to make under this section shall be made to a fund, to be known as the "discharge aftercare fund", which shall be held and jointly administered by the Primary Care Trusts and relevant social services authority in each area.
"(   )  Expenditure from the discharge aftercare fund shall be agreed jointly by the Primary Care Trusts and social services authority in each area."
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

90Page 5, line 12, leave out "responsible NHS body" and insert "Primary Care Trust and spent according to local decision"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

91Page 5, line 13, at end insert "and spent according to an agreement drawn up locally"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

92Page 5, line 14, leave out subsection (10)
93Page 5, line 15, at end insert—
"(   )  No such payments shall be made where the reason for the delayed discharge is not the responsibility of the responsible authority."
94Page 5, line 15, at end insert—
"(   )  This section shall not come into force until 30 days after the Secretary of State has determined that the system of incentives within relevant NHS bodies operates to discourage NHS bodies from discharging patients prematurely."
 

After Clause 4

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

95Insert 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."
96Insert the following new Clause—
  "Recourse to independent advocacy by patient on discharge
  Where it is proposed to discharge a patient on the basis of an assessment of risk to safety but with no assessment of other needs having been undertaken, the responsible authority shall ensure that the patient has recourse to an independent advocate."
 

Clause 5

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

97Page 5, line 21, leave out subsection (2)
 

Clause 6

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

98Page 5, line 28, leave out "may" and insert "shall"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

99Page 5, line 28, "Authority" insert "and local authority"
100Page 5, line 29, after "Board" insert "and local authority"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

101Page 5, line 29, after "Wales" insert "in agreement with their local authority counterparts"
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

102Page 5, line 29, leave out "a" and insert "an independent"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

103Page 5, line 34, leave out paragraphs (a) to (c) and insert—
"(   )  the constitution of a panel;
(   )  the terms of reference and powers of the panel.
(   )  The panel may assist in the resolution of disputes involving bodies not all situated in the area of a Strategic Health Authority or a Local Health Board."
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

104Page 5, line 34, leave out "a panel" and insert "an independent panel comprised, in equal proportions, of representatives from a Strategic Health Authority and from a local authority, with a wholly independent chairman."
105Page 5, line 35, leave out "a" and insert "an independent"
106Page 5, line 36, after "which" insert "independent"
107Page 5, line 38, at end insert—
"(   )  If any regulations are made covering the matters referred to in subsection (2) above they shall include provisions requiring the panel in the case of any dispute to take into account the views of the patient and his carer, if any, or to satisfy itself that the views of the patient or his carer would have no bearing on the panel's findings."
108Page 5, line 44, at end insert—
"(   )  Each independent panel shall publish annually the cost of dispute resolutions."
 

Clause 7

 

THE LORD HUNT OF KINGS HEATH

109*Page 6, line 5, leave out paragraph (a)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

110Page 6, line 19, at end insert—
"(d)  to recover from the responsible NHS body expenditure incurred as the responsible authority for a patient's case in the performance of functions wrongly required of the social services department under section 2(1)(b)."
111Page 6, line 20, leave out from "Part" to end of line 21
 

Clause 8

 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

112Page 6, line 30, leave out from "instrument" to "House" in line 32 and insert "and any such instrument shall not be made unless a draft of the instrument has been laid before and approved by a resolution of each"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

113Page 6, line 30, leave out from "State" to ", to" in line 31
 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

114Page 6, line 32, at end insert—
"(   )  Any regulations made under this Part shall be drawn up in consultation with local government."
 

Clause 9

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

115*Page 6, line 34, at end insert—
 ""assessment" under section 3(3) shall be taken to include the following steps—
(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);
(c)  assessment of the local authorities' duties under section 47(1) of the National Health Service and Community Care Act 1990 (c. 19);
(d)  consideration of the patient's views and wishes;
(e)  an assessment being 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;"
116Page 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));"
 

THE BARONESS FINLAY OF LLANDAFF
THE BARONESS BARKER

117Page 6, line 38, at end insert—
 ""hospice" has the meaning of a place dedicated to the provision of palliative care which may be managed by either the voluntary sector or the NHS;"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

118Page 6, line 41, at end insert—
 ""pilot scheme" shall mean a pilot scheme conducted under Clause (Pilot schemes) above"
119Page 6, line 43, at end insert "and may include a housing authority as well as a social services authority where relevant"

 
back to previous pagecontinue to next page
 
 
House of Commons home page Houses of Parliament home page House of Lords home page search page enquiries index

©Parliamentary copyright 2003
14 February 2003