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

Community Care (Delayed Discharges etc.) Bill


REVISED
MARSHALLED
LIST OF AMENDMENTS
TO BE MOVED
ON REPORT


[Amendments marked * are new or have been altered]

Amendment
No.

 

Clause 1

 

THE EARL HOWE
THE BARONESS NOAKES
THE BARONESS BARKER

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

Clause 2

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

2Page 2, line 7, after "hospital" insert "including independent hospitals which provide health care for which NHS bodies or service providers have responsibility"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES
THE EARL HOWE

3Page 2, line 10, at end insert—
  "and
(c)  has consulted with the patient (and in the case of a carer in relation to assessment under the Carers (Recognition and Services) Act 1995 (c. 12) and the Carers and Disabled Children Act 2000 (c. 16) to ascertain their views and preferences, informed them of the reason for the notification, and obtained their informed consent or in the case where a patient lacks the mental capacity to give such consent, has recorded on the file what steps have been taken to ensure that the patient's best interests have been duly considered"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

4Page 2, line 10, at end insert—
"(   )  a patient has limited mental capacity, a procedure exists to appoint an independent advocate."
 

THE EARL HOWE
THE BARONESS NOAKES

5Page 2, line 11, at beginning insert "Subject to subsection (2A),"
6Page 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 interests have been duly considered."
 

THE LORD HUNT OF KINGS HEATH

7Page 2, line 22, at end insert—
"(   )  Before giving a notice under this section the responsible NHS body must consult—
(a)  the patient; and
(b)  if the body is aware of the identity of a person who is a carer in respect of the patient and it is reasonably practicable to consult him, that carer."
8Page 2, line 23, leave out subsection (4)
 

After Clause 2

 

THE LORD HUNT OF KINGS HEATH

9Insert the following new Clause—
  "Notices under section 2: supplementary
(1)  A notice under section 2 remains in force until the patient to which it relates is discharged, unless it has previously ceased to have effect by virtue of subsection (2) or (3).
(2)  The responsible NHS body may withdraw the notice by giving notice of withdrawal to the responsible authority.
(3)  Regulations may prescribe other circumstances in which the notice ceases to have effect.
(4)  If the notice ceases to have effect before the patient is discharged—
(a)  no further steps under section 3, (Duties of responsible NHS body following notice under section 2), or 4 resulting from the notice shall be taken and no liability (or further liability) to make a payment under section 4(4) shall accrue; and
(b)  the responsible NHS body may (subject to section 2(1)) give a fresh notice under section 2 in relation to the patient;
  but paragraph (a) does not affect any liability which accrues before the notice ceases to have effect.
(5)  Regulations may provide for—
(a)  the form and content of—
(i)  notices under section 2; and
(ii)  notices of withdrawal under subsection (2),
  and the manner in which such notices are to be given;
(b)  circumstances in which notices under section 2 must be withdrawn; and
(c)  determining the day on which a notice under section 2 or a notice of withdrawal under subsection (2) is given (including provision prescribing circumstances in which a notice under section 2 is to be treated for any specified purpose as having been given on a day other than that on which it was in fact given)."
 

Clause 3

 

THE BARONESS BARKER
THE LORD CLEMENT-JONES
THE EARL HOWE

10Page 2, line 39, at end insert "and there has been a decision made that the patient will not require continuing NHS health care other than services provided by the NHS under section 3(8), and a record made of why the patient is considered not to meet each of the criteria for such care, and the patient has been informed of his right of review of this decision."
 

THE LORD HUNT OF KINGS HEATH

11Page 2, line 40, leave out subsection (2)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

12Page 3, line 1, after "assessment" insert "under the single assessment process"
 

THE BARONESS BARKER
THE BARONESS MADDOCK

13Page 3, line 2, after "care" insert "or home improvement"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

14Page 3, line 3, leave out "; and" and insert ", or in the case of a patient receiving NHS funded treatment at a hospital outside the UK, make arrangements for an assessment to be carried out as described in Schedule (Assessment by responsible authority);"
15Page 3, line 4, after "consulting" insert "the patient and having obtained the informed consent of the patient or, in the case where a patient lacks the mental capacity to give such consent to the proposed care plan, having recorded on the file what steps have been taken to ensure that the patient's best interests have been duly considered, and after consulting"
16Page 3, line 4, after "body" insert "and the qualifying patient"
17Page 3, line 5, after "services" leave out "(if any)"
18Page 3, line 5, after "authority" insert ", whether acting as purchaser or provider,"
19Page 3, line 5, at end insert "commensurate with the patient's needs"
 

THE EARL HOWE
THE BARONESS NOAKES

20Page 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."
 

THE LORD MORRIS OF MANCHESTER

21Page 3, line 5, at end insert—
"(   )  Where the responsible authority does not carry out its duty under section 3(3)(a) within the minimum interval prescribed under section 4(2)(b), the responsible NHS body must carry out the assessment of the patient's needs on its behalf."
 

THE LORD HUNT OF KINGS HEATH

22Page 3, line 8, leave out from "person" to end of line 9 and insert "who is a carer in respect of"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

23Page 3, line 15, after "consulting" insert "the carer and obtaining the informed consent of the carer to the proposed care plan and after consulting"
 

THE LORD HUNT OF KINGS HEATH

23A*Page 3, line 17, leave out from "carer" to end of line 19
24Page 3, line 28, at end insert—
"(6A)  The responsible authority must keep under review—
(a)  the needs of the patient; and
(b)  the needs of any carer whose needs it has assessed under subsection (4)(a),
  so far as affecting the services that need to be made available in order for it to be safe to discharge him.
(6B)  The responsible authority may, after consulting the responsible NHS body, alter—
(a)  its decision under subsection (3)(b); or
(b)  any decision taken by it under subsection (4)(b),
  to take account of any change in circumstances since the assessment carried out under subsection (3)(a) or (4)(a) (as the case may be).
(6C)  The responsible authority must inform the responsible NHS body of the decision under subsection (3)(a), of any decision under subsection (4)(a) and of any alteration made under subsection (6B)."
25Page 3, line 29, leave out subsection (7)
 

THE EARL HOWE
THE BARONESS NOAKES

26Page 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."
 

THE LORD HUNT OF KINGS HEATH

27Page 3, line 33, leave out subsections (8) to (10)
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES
THE EARL HOWE

28Page 3, line 34, after "discharge" insert "including, where appropriate, NHS payments for registered nursing care (the level of which must be disclosed to the patient)"
 

THE EARL HOWE
THE BARONESS NOAKES

29Page 3, line 34, after "consult" insert "and agree with"
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

30Page 3, line 35, after "authority" insert "and the patient, and obtaining their informed consent; or, in the case where a patient lacks the mental capacity to give such consent, having recorded on the file what steps have been taken to ensure that the patient's best interests have been duly considered,"
 

THE EARL HOWE
THE BARONESS NOAKES

31Page 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."
32Page 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."
 

THE BARONESS BARKER
THE LORD CLEMENT-JONES

33Page 4, line 9, at end insert—
"(   )  The body charged with the inspection of health services shall have a duty to scrutinise the criteria and their application for continuing NHS health care and NHS payments for nursing care and take action where the body considers them to be over restrictive."
 

After Clause 3

 

THE LORD HUNT OF KINGS HEATH

34Insert the following new Clause—
  "Duties of responsible NHS body following notice under section 2
(1)  The duties under this section apply where notice of a patient's case under section 2 has been given.
(2)  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 available to him in order for it to be safe to discharge the patient.
(3)  The responsible NHS body must give the responsible authority notice of the day on which it proposes to discharge the patient.
(4)  The notice under subsection (3) remains in force until the end of the relevant day, unless it has previously been withdrawn.
(5)  The responsible NHS body may withdraw the notice under subsection (3) at any time before the end of the relevant day by giving notice of withdrawal to the responsible authority.
(6)  For the purposes of this Part "the relevant day", in relation to a qualifying hospital patient, is the later of—
(a)  the day specified in the notice under subsection (3); and
(b)  the last day of the prescribed minimum interval after the notice under section 2 was given.
(7)  Regulations may prescribe a period as the minimum interval after a notice under section 2 is given; but that period 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.
(8)  If the notice under subsection (3) is withdrawn before the end of the relevant day—
(a)  the duty under subsection (3) applies again; and
(b)  when a new notice under subsection (3) is given, subsection (6) applies again for the purpose of identifying a new "relevant day".
(9)  Regulations may provide for—
(a)  the time at which notices under subsection (3) are to be given;
(b)  the form and content of—
(i)  notices under subsection (3); and
(ii)  withdrawal notices under subsection (4);
  and the manner in which such notices are to be given;
(c)  circumstances in which notices under subsection (3) must be withdrawn; and
(d)  determining the day on which a notice under subsection (3) or a notice of withdrawal under subsection (5) is given (including provision prescribing circumstances in which a notice under subsection (3) is to be treated for any specified purpose as having been given on a day other than that on which it was in fact given)."

 
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©Parliamentary copyright 2003
10 March 2003