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Community Care (Delayed Discharges etc.) Bill


Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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A

Bill

[AS AMENDED IN COMMITTEE]

To

Make provision requiring social services authorities to make payments in

cases where the discharge of patients is delayed for reasons relating to the

provision of community care services or services for carers; and to enable the

Secretary of State and the National Assembly for Wales to require certain

community care services and services for carers provided by social services

authorities to be free of charge to persons receiving those services. 

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and

consent of the Lords Spiritual and Temporal, and Commons, in this present

Parliament assembled, and by the authority of the same, as follows:—

Part 1

Delayed discharge payments

Preliminary

 1     Meaning of “NHS body” and “qualifying hospital patient”

     (1)    In this Part—

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                    “NHS body” means—

                  (a)                 a National Health Service trust; or

                  (b)                 a Primary Care Trust (in England) or a Local Health Board (in

Wales); and

                     “qualifying hospital patient” means, subject to subsection (2), a person

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being accommodated at—

                  (a)                 a health service hospital; or

                  (b)                 an independent hospital in pursuance of arrangements made by

an NHS body;

                         who is receiving (or who has received or is expected to receive) care of

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a description prescribed in regulations.

 
HL Bill 3553/2
 
 

Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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

ordinarily resident outside England and Wales.

Determination of need for community care services on discharge

 2      Notice of patient’s likely need for community care services

     (1)    This section applies where—

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           (a)           a person (“the patient”) is or is expected to become a qualifying hospital

patient at a particular hospital after 1st April 2004; and

           (b)           the responsible NHS body considers that it is unlikely to be safe to

discharge the patient from hospital unless one or more community care

services are made available for him.

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     (2)    It is the duty of the responsible NHS body to give notice of the patient’s case

for the purposes of this Part—

           (a)           to the social services authority appearing to the NHS body to be the

authority in whose area the patient is ordinarily resident when the

notice is given, or

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           (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.

     (3)    That notice—

           (a)           must state that it is given under this section; and

           (b)           if given before the day on which the patient is admitted to the hospital,

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must not be given earlier than the beginning of the period of eight days

ending with the day on which he is expected to be admitted.

     (4)    Regulations may prescribe—

           (a)           the form and contents of notices under this section and the manner in

which they are to be given;

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           (b)           circumstances in which such notices may be withdrawn or in which

they otherwise cease to have effect.

     (5)    In this Part “the responsible NHS body”, in relation to a person who is or

expected to become a qualifying hospital patient, means—

           (a)           if the hospital concerned is a health service hospital, the NHS body

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managing the hospital; or

           (b)           if the hospital concerned is an independent hospital, the NHS body

making the arrangements for the patient to be accommodated.

     (6)    In this Part “the responsible authority”, in relation to a person whose case has

been notified under this section, means (subject to any regulations under

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section 7) the social services authority to which the notice is given.

 3     Duties arising where a notice under section 2 is given

     (1)    The duties in this section apply where notice of a patient’s case has been given

under section 2.

     (2)    But those duties cease to have effect if the notice is withdrawn or otherwise

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ceases to have effect before they are complied with.

     (3)    The responsible authority must—

 

 

Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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           (a)           carry out an assessment of the patient’s needs with a view to

identifying any community care services that need to be made available

in order for it to be safe to discharge him; and

           (b)           after consulting the responsible NHS body, decide which of those

services (if any) the authority will make available for the patient.

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     (4)    The responsible authority must, in the circumstances mentioned in subsection

(5), also—

           (a)           carry out an assessment of the needs of any person who provides or

intends to provide a substantial amount of care on a regular basis for

the patient (“the carer”) with a view to identifying any services which—

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                  (i)                 the authority may provide under section 2 of the Carers and

Disabled Children Act 2000 (c. 16)); and

                  (ii)                need to be made available to the carer in order for it to be safe

to discharge the patient; and

           (b)           after consulting the responsible NHS body, decide which of those

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services (if any) the authority will make available to the carer.

     (5)           The duties in subsection (4) apply only where the carer, being a person entitled

to ask for an assessment under section 1 of the Carers and Disabled Children

Act 2000—

           (a)           asks the responsible authority to carry out an assessment under

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subsection (4); or

           (b)           has, within the period of twelve months ending with the day on which

the notice under section 2 was given (or at any time after that day),

asked the responsible authority to carry out an assessment under

section 1 of the Carers and Disabled Children Act 2000.

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     (6)    The duties in subsection (3) or (4) apply whether or not the patient’s needs for

community care services or the carer’s needs for services (as the case may be)

have previously been assessed.

     (7)    If it appears to the responsible NHS body that the patient’s circumstances have

changed after the decision required by subsection (3)(b) or (4)(b), the NHS

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body may withdraw the notice and, if it considers it appropriate to do so, give

a further notice under section 2.

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

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

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

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

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

day on which it proposes to discharge the patient.

     (10)   Regulations may prescribe—

           (a)           the time at which notices under subsection (9) are to be given;

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           (b)           the form and contents of such notices and the manner in which they are

to be given;

           (c)           circumstances in which such notices may be withdrawn or in which

they otherwise cease to have effect.

     (11)   Anything done under subsection (3) above is to be treated as done under

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section 47(1) of the National Health Service and Community Care Act 1990 (c.

19) (but without prejudice to anything to be done under that section in relation

to any other community care services).

 

 

Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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     (12)   Anything done under subsection (4) above is to be treated as done under

section 1 or 2 of the Carers and Disabled Children Act 2000 (c. 16) (but without

prejudice to anything to be done under that section in relation to other services

which may be provided to the carer).

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

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

impact of this Act on patients and their carers.

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

outcomes of patients affected by this Act.

Delayed discharge payments

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 4     Liability to make delayed discharge payments

     (1)    This section applies where, in the case of a person who is a qualifying hospital

patient—

           (a)           notice of his case has been given under section 2 (and not withdrawn);

and

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           (b)           notice of the proposed discharge day has been given under section 3(9).

     (2)    For the purposes of this section “the relevant day” is the later of—

           (a)           the proposed discharge day notified under section 3(9); and

           (b)           the last day of the period prescribed by regulations as the minimum

interval after a notice under section 2 is given.

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     (3)    The period prescribed under subsection (2)(b) 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.

     (4)    If by the end of the relevant day—

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           (a)           the responsible authority has not complied with its duties under section

3(3); or

           (b)           it has not been possible to discharge the patient because, and only

because, either of the conditions in subsection (5) is satisfied (or both

are satisfied),

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            the responsible authority must make a payment of the amount prescribed in

regulations for each day of the delayed discharge period.

     (5)    The conditions referred to in subsection (4) are that—

           (a)           the responsible authority has not made available for the patient a

community care service which it decided under section 3(3)(b) to make

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available for him;

           (b)           the responsible authority has not made available for the patient’s carer

a service which it decided under section 3(4)(b) to make available to the

carer.

     (6)    For this purpose “the delayed discharge period” is, subject to subsections (7)

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and (8), the period—

           (a)           beginning with the day after the relevant day, and

           (b)           ending with the day on which the patient is discharged.

 

 

Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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     (7)    If on any day before that on which the patient is discharged the responsible

authority gives notice to the responsible NHS body that—

           (a)           it has complied with its duties under section 3(3),

           (b)           every community care service that it decided under section 3(3)(b) to

make available has been made available for the patient, and

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           (c)           every service that it decided under section 3(4)(b) to make available to

a carer has been made available,

             the delayed discharge period ends with that day.

     (8)    Regulations may—

           (a)           require days after the relevant day not to be treated as days of the

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delayed discharge period;

           (b)           prescribe circumstances (other than those mentioned in subsections (6)

and (7)) in which the delayed discharge period ends;

           (c)           make provision for determining the day on which a notice under

section 2 or 3(9) is given (including provision prescribing

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circumstances in which a notice is to be treated for the purposes of this

section as having been given on a day other than that on which it was

in fact given);

           (d)           make provision for determining the day on which a patient is

discharged (including provision prescribing circumstances in which a

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patient is to be treated for the purposes of this section as having been

discharged on a day other than that on which he was in fact

discharged).

     (9)    Any payment which a social services authority is required to make under

subsection (4) shall (subject to subsection (10)) be made to the responsible NHS

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body.

     (10)   If the case is of a description prescribed in regulations the payment shall be

made to the person prescribed in relation to cases of that description.

Disputes

 5     Ordinary residence

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     (1)    Any question arising under this Part as to the ordinary residence of a person

who is or is expected to become a qualifying hospital patient shall be

determined by the Secretary of State or by the Assembly.

     (2)    The Secretary of State and the Assembly must make and publish arrangements

for determining which cases are to be dealt with by the Secretary of State and

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which are to be dealt with by the Assembly.

     (3)    Those arrangements may include provision for the Secretary of State and the

Assembly to agree, in relation to any question that has arisen, which of them is

to deal with the case.

 6     Dispute resolution

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     (1)    Regulations may require each Strategic Health Authority in England and each

Local Health Board in Wales to establish and maintain a panel to assist in the

resolution of disputes under or in relation to this Part between two or more

public authorities (other than disputes to which section 5 applies).

 

 

Community Care (Delayed Discharges etc.) Bill
Part 1 — Delayed discharge payments

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     (2)    Regulations may make provision about the panels to be established by virtue

of this section, including in particular provision about—

           (a)           the constitution of a panel in the case of any dispute referred to it;

           (b)           which disputes may be referred to a panel; and

           (c)           which panel may assist in the resolution of disputes involving bodies

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not all situated in the area of a Strategic Health Authority or a Local

Health Board.

     (3)    Regulations may prohibit a public authority from bringing legal proceedings

against another public authority in relation to a dispute under this Part before

such steps have been taken in relation to a panel established by virtue of this

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section as may be prescribed in the regulations.

     (4)    For the purposes of this section “public authority” means an NHS body or a

social services authority.

Supplemental

 7     Adjustments between social services authorities

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     (1)    Regulations may make provision as to the application of this Part in cases

where, in relation to a qualifying hospital patient, it appears to the responsible

authority for the time being that the patient is ordinarily resident in the area of

another social services authority.

     (2)    The regulations may, among other things, authorise or require a social services

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authority—

           (a)           to accept a notice given to it under section 2 notwithstanding that it

may wish to dispute that it was the right authority to be notified;

           (b)           to become the responsible authority for a patient’s case in place of the

social services authority previously responsible;

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           (c)           to recover expenditure incurred as the responsible authority for a

patient’s case in the performance of functions under this Part, or in the

provision of community care services which are the subject of a

decision under section 3(3)(b), from another social services authority.

     (3)    The regulations may modify the effect of any provision of this Part as it applies

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in any cases falling within subsection (1).

 8     Regulations

     (1)    Any power to make regulations under this Part is exercisable by the

appropriate Minister.

     (2)    Regulations under this Part may—

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           (a)           make different provision for different cases and circumstances;

           (b)           make supplementary, consequential, incidental, transitional or saving

provision.

     (3)    Any power to make regulations under this Part is exercisable by statutory

instrument subject, in the case of regulations made by the Secretary of State (or

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by the Secretary of State and the Assembly acting jointly), to annulment in

pursuance of a resolution of either House of Parliament.

 

 

 
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