Covid 19 Update to Providers
The Covid-19 update provides insights into the current situation in Bristol and Bath & North East Somerset councils, highlighting system pressures, care home closures, and ongoing support for healthcare providers. It discusses the impact of new financial reforms and NHS changes, including workforce challenges and initiatives to manage demands. Additionally, it touches on the government's plan for funding healthcare and social care reforms published in September 2021, focusing on the National Insurance levy and the cap on individual care costs.
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Presentation Transcript
Covid 19 Update to Providers Stephen Beet Bristol City Council Suzanne Westhead Bath & North East Somerset Council
Content The Covid Position/ System Pressures Stephen Beet/Suzanne Westhead Build back better- the New financial reforms Providers uplifts for Bristol and BANES Bristol & BANES strategic intentions New NHS reforms/ Integrated Care Systems Suzanne Westhead Stephen Beet/Suzanne Westhead Stephen Beet/Suzanne Westhead Stephen Beet
Covid numbers decreasing but higher than England average 18 care homes closed to admissions 46 home care packages waiting to be sourced (reduced) System on OPEL 4 Large no of patients medically fit for discharge and daily targets set 105 P3 beds currently commissioned and lack of permanent capacity Ongoing support to providers with recruitment/ retention Bristol Covid Update
Covid numbers are decreasing in care homes and hospital 15 care homes closed Providers are returning small number of Domiciliary care packages System as in Bath Wiltshire and Swindon BSW is on Opel 4 Bath & North East Somerset is setting up an internal Domiciliary care service to manage the demand Workforce challenges The Bath & North East Somerset Covid Position
1. In September 2021, the government published its plan for reforming funding for Health and Social Care (Build Back Better), which included: A National Insurance levy of 1.25%, to provide an additional 12bn per year of funding for Health and Social Care; in the first three years, this money will be ring-fenced for the NHS, and after this period it will gradually move to funding Social Care A cap of 86k on the amount any individual can spend on their personal care over a lifetime; this will be monitored through a Personal Care Account and once this cap is reached, care will be funded by the Local Authority Build Back Better- Financial Reforms Means testing, which means anyone with assets of less than 20k will not pay for their care at all, and anyone with assets between 20k and 100k will receive some assistance (where a person receives support from the state to pay for their care, the 86k cap will still apply to the individual s personal contribution) Those who pay for their own care will be supported to be assessed by their Local Authority, and will be able to ask the Local Authority to source and broker their care for them; this is designed to establish a consistent price for care ( fair cost of care ), where care is funded by the Local Authority or privately (currently those paying for their own care typically pay more for their care)
People at the Heart of Care white paper for reforming the delivery of Adult Social Care (People at the Heart of Care) which aims to set out a 10 year vision and includes three objectives: In December 2021, the government also published its People have choice, control, and support to live independent lives People can access outstanding quality and tailored care and support People find adult social care fair and accessible
So, What does all that mean for the sector
The government is requiring that the council submit to the Department of Health and Social Care in September 2022: a cost of care exercise produced by surveying local providers for 65+ residential and nursing care and 18+ homecare to determine a sustainable fee rate for different care settings. Exercises will need to accurately reflect local costs such as staff pay and travel time and provide for an appropriate return on capital or return on operations. Local authorities will be expected to publish the exercises a provisional market sustainability plan setting out local strategy for the next 3 years (2022 to 2025) using the cost of care exercise as a key input, this provisional plan will demonstrate the pace at which local authorities intend to move towards a sustainable fee rate, in particular taking account of other pressures they have identified. This should include strategic planning for changes in types of provision in response to local need with other local areas, taking into consideration the role of new models of care (including housing) It could help
The care market in B&NEs, as in other areas, is under considerable stress with many local providers struggling to recruit and retain staff and deliver the capacity and volume of care required both in terms of community need and those being discharged from hospital. Competition from other areas of the employment market such as hospitality and retail are drawing a significant number of people away from the care market, as the rates of pay are often significantly above what care providers are able to pay. ADASS feel that work force is one of the biggest issues facing adult social care and is likely to lead to a significant cost pressure which may far out way inflationary costs Uplifts
BANES are just about to write to their providers with our offer We will where the Fair Price of Care (FPOC) is not met we will uplift. Where providers request an uplift and they are on the FPOC we will discuss and have an open book approach to ensure we support the provider Bathnes proposed uplift
Currently going through the process of calculating the fee uplifts for 2022/23. Complex process, considering Real Living wage, national and local care markets, and specific contractual requirements within each contract. Working within the parameters of a total corporate uplift budget for, a share of which goes to Adult Social Care services. Bristol City Council s final budget position and consequent uplifts will be agreed at the meeting of the full council on 15 February 2022 Bristol proposed uplift
It is very difficult to predict inflationary pressures during the year and how the impact of competition from other employers will play out and impact on the care market. The view of the ADASS finance lead is that the inflationary pressures facing adult social care in 22/23 will a minimum of 6% and potentially more: 6.6.% Nation minimum wage increase which applies to 70% of care costs- general inflation of 2.5% which applies to 30% of the care costs plus the NI increase to cover the social and health care levy O.5% which brings the total to just under 6%. The Risks
People have choice, control, and support to live independent lives People can access outstanding quality and tailored care and support Strategic Intentions People find adult social care fair and accessible Home is nearly always best
The NHS will work as an equal partner with local government Will provide a flexible, enabling framework for local partners to build on existing partnerships at place and system levels Systems will agree their own arrangements to suit particular circumstances and characteristics. ICS will be statutory bodes to be accountable for delivery of health services, integration and population health outcomes from April (now July) 2022. Health and Care Bill published July 2021 NHS Reforms and Integrated Care Systems
