North Yorkshire Council

Health and Adult Services

Executive Member Meeting

20^th October 2023

REPORT TO Corporate Director of Health and Adult Services (HAS) in consultation with the

Executive Member for Health and Adult Services

Provision of Integrated Community Equipment Service from 1^st December 2023

1.0 Purpose Of Report (required)

To recommend a direct award utilising an appropriate framework to provide an Integrated Community Equipment Service from 1^st December 2023 when the current contract expires.

2.0 Background

Integrated Community Equipment Services (ICES) are commissioned on behalf of Humber and North Yorkshire ICB (NY Place and York Place), North Yorkshire Council, and West Yorkshire ICB (for the Craven area. The current contract, which is an activity-based contract is due to expire on 30^th November 23.

The ICES contract has played an important role in the response to the Covid pandemic through an urgent discharge service, authorised by commissioners through a rota. Other partnership developments have included: establishing a new York-based store with additional capacity to respond to health, safety and quality concerns; agreeing prescriber roles and responsibilities document; ensuring continued provision of equipment through a process of identifying and agreeing Close Technical Equivalents in response to national shortages; and commencing a Pin matrix review.

High quality care equipment, aids and adaptation services are a vital component to the independence of people of all ages with health conditions, disabilities and/or mobility issues. Care equipment services provide the gateway to the independence, dignity, and self-esteem of not only the service users but their families and carers too.

The Care and Support Statutory Guidance, issued under the Care Act (June 2014) states that local authorities must promote integration between care and support provision and health and health related services, with the aim of joining up services. The integration of the Community Equipment Service shall facilitate this whilst:

Promoting the wellbeing of children, young people and adults with care and support needs.
Contributing to the prevention or delay of the development needs of people.
Improving the quality of care and support and a positive impact on outcomes for service users and their parents/carers.
Facilitating Prevention: through the prevention of admissions to hospitals or care homes, delayed transfers of care and ill health; for example, by reducing pressure sores and delaying the deterioration of health.
Facilitating Independence: through the provision of the right equipment which can help people maintain their independence by allowing people to continue to carry out everyday tasks such as toileting, bathing, feeding, and drinking. Equipment can also help with mobility.
Facilitating Caring: through the provision of the right equipment, equipment can enable care and nursing needs to be attended to in a community setting by either paid or family carers. Equipment can keep the carer safe when moving and handling is required preventing injury to the carer and reducing the need for home care packages.

3.0 Issues

The existing contract is due to expire on 30^th November 2023. The contract is commissioned in partnership with Humber and North Yorkshire ICB and West Yorkshire ICB and there is a joint ambition to undertake a full-scale review of the service to ensure a more integrated approach to commissioning this service in the future.

Given the requirement for this review, a direct award of the contract to maintain continuity is recommended until 31^st March 2025. Time is also required to consider commissioning and contracting options with a procurement exercise following the comprehensive review.

The demand for this service has increased and given the nature of the contract it is over trading currently. The incumbent provider and commissioners have a management plan in place to address this.

To ensure the stability of the services in supporting hospital discharge and a sustained increase in demand, the joint commissioning team have recommended a direct award of the contract from an established framework.

4.0 Alternative Options considered

Alternative options, including procurement have been considered but this is not recommended in the remaining timescale of current contract.

Given the service supports statutory requirements, a termination of the contract has not been considered.

5.0 Financial Implications

The existing contract is overtrading; however, a robust plan is in place with commissioners and the provider to manage this during the proposed contract timeframe.

6.0 Legal Implications

The proposed new contract will be a Direct Award via the SBS framework, this represents a compliant route to the market and is the preferred option based on procurement and legal advice.

7.0 Consultation undertaken and responses

The incumbent provider and all commissioning parties are in agreement with the approach. The direct award will enable a full review of the service, this will be undertaken in partnership with people who use the service and their families/carers.

8.0 Impact on other services/organisations

Both commissioning and provider organisations are in agreement with the proposed approach.

9.0 Contribution to Council priorities

This contract supports the directorate and wider Council priorities to achieve a Home first approach to care and support and to prevent hospital admission and promote timely hospital discharge.

10.0 Reasons for recommendation/s

The recommendation will enable the continuity and stability of equipment provision across North Yorkshire and provide an opportunity for a comprehensive review of the service ahead of future potential procurement.

14.0 Recommendation/s (required)

To agree to a direct award utilising an appropriate framework for provision of an Integrated

Community Equipment Service until 31^st March 2025 (including an option to extend until

31^st March 2026)

Name and title of report author

Mandy Welsh

Head of Care & Support - Craven