Decision details

i.      the proposal for an integrated and delegated continuing health care (CHC) service for East Berkshire is endorsed.

ii.     officers are instructed to proceed with the design and development of

the trusted assessor operating model and implementation plans to pilot this from July 2019.

1.    There is substantial evidence that more personalised health and care for people with continuing health care needs delivers better outcomes, higher satisfaction levels and is often more cost effective.

2.    The use of personal health budgets and direct payments puts patients directly in control of their care and potentially opens up a wider range of community delivered health and care options that can be purchased directly in the local care market. For example people can use their personal health budget to directly employ a health care assistant or to fund established care arrangements rather than have to give these up if they become eligible for NHS funded continuing health care

3.    Bracknell Forest Council’s Adult Social Care team already supports the CCG with CHC care management for people with learning disabilities, and led the development of a personal health budget (PHB) direct payment support service for the CCG in 2017.

4.    Greater integration across health and social care is a strategic priority for the Council and NHS partners. Bracknell Forest Council and the other East Berkshire local authorities already have a strong track record of collaboration and integrated working which is reflected in the plans to develop the Frimley Health and Care Partnership integrated care system.

5.    A local authority hosted CHC assessment and care management service will create opportunities to pool resources, share the benefits of better managed continuing health care and minimise the risk of dispute.

1.    A range of alternative approaches have been considered including a do nothing option. This was discounted because there is agreement amongst CCG and local authority partners that the current CHC service has led to inconsistencies in assessment and care management practice, choice of provision, as well as disjointed pathways, duplication of resources and avoidable disputes.

2.    The development of a joint enterprise would support the benefits of integration but it was felt that establishing new structures and organisations would involve TUPE, and the governance and transitional requirements and costs would be too complex and expensive.

3.    The model outlined in the proposal, achieves the benefits of integrated

commissioning and allows for a period to evaluate the impact without the need for creating new organisations and unnecessary costs.

4.    The same principles will be applied to the development of an integrated assessment and care management model.

None