Issue - meetings

Following on from the previous report to Panel in September 2020, attached is an update report on Virgin Care. The report has focussed on the Integrated Reablement Service and the financial performance of the contract in year 4 of the 7 year term as requested by the Panel.

The Director of Adult Social Care, Complex and Specialist Commissioning introduced this item to the Panel alongside the Head of Contracting & Performance, a summary is set out below.

COVID-19 Impact

COVID-19 has had a significant impact on the Reablement Service and the delivery of reablement within B&NES. Following the release of the Hospital Discharge Guidance by the Department of Health and Social Care, all health and care systems were required to deliver the ambitions of Discharge to Assess (D2A) to ensure the safe and timely discharge of people who no longer needed to stay in hospital.

In response to the D2A requirements, it was agreed in B&NES that the

Integrated Reablement Service would be the service that would support

individuals being discharged on Pathway 1 (home with additional support).

This meant the Service would support all individuals who needed a new or

increased package of care on discharge to be supported and assessed by the

Service, prior to their long-term care needs being determined and arranged. In

addition, the Service would be responsible for the case management of such

individuals, including the administrative processes associated with this.

Due to this change, people who would have traditionally been discharged

from hospital directly into a local authority/self-funded long-term package of

care now have an assessment and support offer from Reablement for up to

six weeks.

Performance

Performance and activity for the Reablement Service has been significantly impacted by COVID-19.

After an initial fall in referrals in April 2020, as services and services users were adapting to the national lockdown, the trend since then has been a significant increase. In the year to date to the end of January 2021, average monthly referrals are 7.9% higher than the 2019/20 average. In parallel, the number of discharges from the Service has seen an increase over the past year since January 2020.

While the number of people receiving a service per month has dropped compared to the 2019/20 average by 6.4%, the number of contacts has risen

significantly, with 20.4% more contacts on average per month than the

2019/20 average. As a consequence, length of stay in the Service has increased above average levels for the three years prior to April 2020. While

the monthly average in 2020/21 is 4.0% above the 2019/20 average, the

shorter length of stay in the first quarter of 2020/21 is offsetting the high levels

seen currently. To put this in context, the latest value for January 2021 is

24.2% above the 2019/20 average.

The peak caseload in November 2020, at 662 people, is 37.1% higher than the 2019/20 peak of 483 (January 2020). The latest data shows that the caseload is reducing but it remains high relative to previous years.

Despite the pressures on the Service, performance for the ASCOF measure

(which reviews whether people remain in their usual place of residence 91

days after discharge into reablement from hospital) remains close (82.1%) to the targeted level of 85%.

Reablement Next Steps

For the Integrated Reablement Service  ...  view the full minutes text for item 77