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

Community Care (Delayed Discharges etc.) Bill


AMENDMENTS
TO BE MOVED
ON REPORT


 

Clause 1

 

THE EARL HOWE
THE BARONESS NOAKES

Page 1, line 10, at end insert "other than a person receiving mental health services"
 

Clause 2

 

THE EARL HOWE
THE BARONESS NOAKES

Page 2, line 11, at beginning insert "Subject to subsection (2A)"
Page 2, line 17, at end insert—
"(2A)  Before giving the notice referred to in subsection (2), 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 interest have been duly considered."
 

Clause 3

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 3, line 1, after "assessment" insert "under the single assessment process"
 

THE BARONESS BARKER
THE BARONESS MADDOCK

Page 3, line 2, after "care" insert "or home improvement"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 3, line 4, after "body" insert "and the qualifying patient"
Page 3, line 5, after "services" leave out "(if any)"
Page 3, line 5, after "authority" insert ", whether acting as purchaser or provider,"
Page 3, line 5, at end insert "commensurate with the patient's needs"
 

THE EARL HOWE
THE BARONESS NOAKES

Page 3, line 5, 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."
Page 3, line 32, at end insert—
"(   )  The responsible body must consider whether any other NHS body should consider providing services to the patient after discharge and must provide information about the patient to any such NHS body for that purpose."
Page 3, line 34, after "consult" insert "and agree with"
Page 3, line 36, 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."
Page 3, line 38, 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."
 

Clause 4

 

THE EARL HOWE
THE BARONESS NOAKES

Page 4, line 24, at end insert "excluding Saturdays, Sundays and public holidays"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 4, line 25, at beginning insert "Subject to subsection (4A),"
Page 4, line 32, 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."
Page 5, line 24, 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, which shall be held and joint administered by the Primary Care Trusts and relevant social services authority in each area.
(   )  Expenditure from this funds shall be agreed jointly by the Primary Care Trusts and social services authority in each area to provide any of the services made available under Schedule (Assessment by responsible authority)."
 

THE EARL HOWE
THE BARONESS NOAKES

Page 5, line 28, 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."
 

Clause 6

 

THE EARL HOWE
THE BARONESS NOAKES

Page 5, line 41, after "Authority" insert "and local authority"
Page 5, line 42, after "Board" insert "and local authority"
Page 6, line 3, after "panel" insert "(which, if so established, shall be independent of the parties in dispute and comprised equally of representatives from a Strategic Health Authority and local authority, with a wholly independent chairman)"
Page 6, line 7, at end insert—
"(   )  Any regulations are made covering the matters referred to in subsection (2) 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."
 

Clause 8

 

THE EARL HOWE
THE BARONESS NOAKES

Page 6, line 42, at end insert—
"(   )  Any regulations made under this Part shall be drawn up in consultation with local government."
 

Clause 12

 

THE EARL HOWE
THE BARONESS NOAKES

Page 8, line 41, at end insert—
"(   )  Any regulations made under this section shall be drawn up in consultation with local government."
 

Clause 13

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 9, line 4, at end insert—
"(   )  The Assembly may by regulations made by statutory instrument require that any community care services provided by local authorities in Wales, in discharging any statutory function, may be provided free of charge to the person to whom they are provided."
 

Clause 14

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Page 9, line 25, at end insert—
"(   )  In section 7 of the Health and Social Care Act 2001 (c. 15) (function of overview and Security Committees), after subsection (2) there is inserted—
"(2A)  The overview and scrutiny committee shall agree and adopt with local NHS bodies in their area, joint local protocols as regards the discharge of hospital patients, to include—
(a)  action plans to prevent and reduce delayed discharges,
(b)  administrative and practical arrangements for the implementation of the Community Care (Delayed Discharges) Act 2003, 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 of the Community Care (Delayed Discharges) Act,
(e)  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,
(f)  joint agreement on how payments made under section 4 of the Community Care (Delayed Discharges) Act 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.
(2)  An action plan under this section is a document drawn up by the relevant bodies specifying the 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 of the Community Care (Delayed Discharges) Act.""
 

After Clause 17

 

THE EARL HOWE
THE BARONESS NOAKES

Insert the following new Clause—
  "Duration
(1)  Subject to subsection (2), Part 1 of this Act shall cease to have effect at the end of five years beginning with the date on which it comes into force.
(2)  If the Secretary of State is satisfied that it is necessary for social services authorities to continue making payments in cases where the discharge of patients is delayed for reasons relating to the provision of community care services or services for carers, he may make an order providing that Part 1 of this Act shall continue in force for a further five years.
(3)  An order may not be made under subsection (2) unless a draft of that order has been laid before, and approved by resolution of, both Houses of Parliament."
 

Schedule 1

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

Insert the following new Schedule—
  "SCHEDULE—Assessment by responsible authority
  Further to the fulfilment of the requirements under section 3(3)(a) a single assessment process shall be taken to mean a comprehensive assessment and follow up, by a multi-disciplinary team, under the following statutory categories—
(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)  assessment of whether the patient qualifies for any services provided under section 29 of the National Assistance Act 1948 (c. 29) (welfare services);
(e)  assessment of entitlement to any services under section 45 of the Health Services and Public Health Act 1968 (c. 46) (promotion by local authorities, of the welfare of old people);
(f)  assessment of need for, and entitlement to, any of the services set out in section 2(1) of the Chronically Sick and Disabled Person Act 1970 (c. 44) (provisions of welfare services);
(g)  assessment of needs for any additional services made available as a result of guidance issued under section 7(1) of the Local Authority Social Services Act 1970 (c. 42) (local authorities to exercise Social Services functions under guidance of Secretary of State);
(h)  assessment of the patients rights, or those of the patients carers or advocates, under the Disabled Persons (Services, Consultation and Representation) Act 1986 (c. 33);
(i)  consideration of the patient's views and wishes, or in any case where the patient lacks mental capacity, the views and wishes entitled person to be his advocate, his nearest relative as defined in section 29 of the Mental Health Act 1983 (c. 20) (appointment by court of acting nearest relative), his receiver appointed under Part VII of the Mental Health Act 1983 (management of property and affairs of patients), his attorney or attorneys appointed in accordance with the Enduring Powers of Attorney Act 1985 (c. 29), or any person who accrues such rights under successor legislation;
(j)  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;
(k)  assessment of the appropriateness of available accommodation, 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)."

 
 
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©Parliamentary copyright 2003
4 March 2003