Open list for D2A

Buckinghamshire Council is working in partnership with the Clinical Commissioning Group and the wider health and social care system to sustain and continue the development of a robust Discharge to Assess (D2A) pathway through the commissioning of Home care packages and care home placements. Discharge to Assess is a pathway which has been successful in reducing acute bed occupancy. It is designed to be a nimble process that facilitates rapid discharge from hospital of medically optimised individuals, enabling acute and community hospitals to maintains capacity and respond to pressures, whether seasonal or due to the demands of Covid-19. This pathway enables assessments of long term needs to take place in a setting that is less restrictive than hospital, ensuring longer term packages of care and support are reflective of the person’s maximum abilities. Some people may require this support for a period of up to a maximum of 6 weeks depending on the assessment. Our philosophy in Buckinghamshire is Home First. Whilst most people will be discharged home without the need for any extra funded support, some will have care and support needs that require D2A Home care Providers. This will provide care and support at home whilst social care needs assessments, and occasionally NHS Continuing Healthcare Assessments of eligibility, are undertaken in a community setting. It is expected that Home care providers will accept D2A service users that are Covid-19 positive but have been asymptomatic for 48 hours and also those that are post 14 days isolation and Covid-19 recovered. If discharge home is not possible due to safety or client need, a care home placement may be considered. The duration of each service user’s placement in the D2A package of care or placement will be determined by the time taken to identify long term needs and funding arrangements. For most service users this will be within two weeks, but where CHC eligibility requires a full assessment, this may be up to six weeks. Service users are expected to move through the pathway as quickly and safely as is possible for them. Buckinghamshire Council is seeking to establish a list of Care Providers who would be willing to accept D2A service users. Care Providers will be required to complete various pass/fail criteria to obtain access onto the list. When an individual requires a D2A placement, Care Providers will be selected from the list based on availability, the specific needs of the individual, affordability and accessibility. At times, we may need to acquire a number of domiciliary care hours in one geographic area or a number of care home beds in one location. On these occasions a block contract may be offered to one or several Care Providers on the open list. We are seeking providers of the following: • Domiciliary Care • Live in Care • Complex Domiciliary Care • Residential Care • Nursing Care • Dementia Nursing Care • Dementia Residential Care • Care homes able to manage specific needs relating to mental health or spinal patients The list is intended to be in place from the 21st of June Care Providers will be expected to respond to referrals sent to them within 2 hours and pick up and start packages within 24 hours. They will also need to be flexible in response to requests to increase/decrease block provision as required to meet demand over this period. This is important given the uncertainty of demand due to potential increases and decreases in cases of the Covid-19 and ongoing pressures on the hospital trust. We invite Care Providers who wish to provide these services to review the documentation and submit the statement document via the messaging function on the Buckinghamshire Business Portal (www.supplybucksbusiness.org.uk) The contract and specification have been attached for your information at this stage. Once a care provider is named on the list there is no guarantee that care hours will be offered. We are particularly interested in working with Home care providers that are available to cover the following areas: • Marsh Gibbon • Brill • Boarstall • Oakley • Worminghall • Ickford • Chiltern • Long Crendon • Dagnell • Ibstone • Turville • Hambleden • Frieth • Rockwell End • Amersham • Cheddington • Beacons Bottom • Stokenchurch • Leighton Buzzard We are also particularly interested in working with care providers that specialise in complex care. Buckinghamshire Council may request that a Spot Placement Agreement is in place prior to the provider being approached for individual spot placements. The Spot Placement Agreement will outline the terms in which the spot placements are delivered. It will include a composite hourly rate that has been negotiated and agreed by Commissioners and the care provider. It will be the expectation that these terms will be adhered to through the duration of the agreement. Any providers not currently approved by Buckinghamshire Council will have to go through an additional quality monitoring process to obtain approval before any contracts are awarded.