Funding for Family Nursing and Home Care services – petition.

STATES OF JERSEY

FUNDING FOR FAMILY NURSING AND HOME CARE SERVICES – PETITION

Lodged au Greffe on 15th November 2016 by Deputy G.P. Southern of St. Helier

STATES GREFFE

2016  P.122

PROPOSITION

THE STATES are asked to decide whether they are of opinion

to note that 2,026 petitioners have signed a petition for which the Jersey Branch of Unite the Union is responsible and –

to request the Minister for Health and Social Services to maintain the present funding for Family Nursing and Home Care services until a funding-stream through the Long-Term Care (LTC) Fund and Income Support Personal Care level 4 component is approved by the Assembly and put in place to cater for potential demand.

DEPUTY G.P. SOUTHERN OF ST. HELIER

REPORT

Since at least 2014, the Minister for Health and Social Services has been attempting to change the mechanism for the delivery of home care and nursing services in the Island. This has involved significant changes for the funding of the services involved.

The transition from a system in which subsidised services have largely been delivered through the Family Nursing and Home Care ("FNHC") organisation to one in which some 20 home care agencies compete to deliver services commissioned by individual clients is a complex one, made worse by the absence of a detailed breakdown of the block funding involved.

The response to question 9681 on 1st November revealed that district nursing, home care and children's services, including health visiting, school nurses and community paediatrics, were all included in a block grant of around £6 million.

The Minister indicated that much work was needed to reach agreement –

"In the contract meeting on 29th July 2016, it was agreed that the 2017 service specifications would be finalised by 31st October 2016, with the funding to be agreed no later than 30th November 2016. The 2017 contract would include:

• Full funding of District Nursing service (formula to be agreed)
• Full funding of Children's Services (formula to be agreed)
• No further funding for Homecare services (i.e. no continuation of the subsidy)
• Rapid response and reablement to be funded at 2016 (full year effect) rate of £855,000, adjusted for impact of any additional posts as agreed by Community & Social Services, plus additional posts for mental health services (total budget for service £1,460,000)."

He also stated that "a later start date" was under consideration.

At a meeting with the Health and Social Services Scrutiny Panel on 10th November, the Director of System Redesign revealed that "the 2017 funding is at the same level as the 2016 funding"; and the Minister confirmed that the transition period had been extended to the beginning of 2018.

It might appear to some that this assurance renders the need for this petition and proposition redundant, and in a perfect world, there would be no need for a debate. However, there are further issues which need to be resolved and in place before we can be assured that this major transition will not adversely affect clients in receipt of home care. These include –

• drafting of legislation for the introduction of Personal Care level 4 ("PC4") (flexible care)
• inclusion of the assessment mechanism for PC4 by July 2017
• ensuring that all potential (new and existing) recipients of PC4 are assessed
• ensuring that all potential (new and existing) recipients of LTC are assessed
• resolution of staffing issues, including potential redundancies and changes to terms and conditions which require negation and agreement between FNHC management and Unite the Union.

Financial and manpower implications

There are no direct financial or manpower implications for the States arising from the adoption of this proposition.

APPENDIX

2,026 signatures