Appendix 1 B

Partnership Agreement

Pooled Budget Arrangements

Social Care and NHS Funded Nursing Care in Care Homes with Nursing

October 2003 No. 1

Introductory Remarks

• This partnership agreement came into effect 1^st April 2003.

• It is a requirement of the agreement that a cross agency Management Board oversees the ‘operation’ of the agreement in relation to Activity and Finance.

• The Management Board met for the first time in August, at that meeting a review of the Partnership Agreement revealed a small number of technical/operational issues which, with the guidance of the Director of Finance for the PCT, pragmatic solution have been agreed. These do not materially affect the Partnership Agreement.

• Quarterly Finance and Activity reports will be submitted to the PCT Board and Social Services & Housing Select Committee, Report No. 1 follows below.

Free Nursing Care - Administration arrangements

• The system for linking with social service and the payment of clients is working well.

• Assessments are carried out within the stipulated time required by the Free Nursing Care Guidance

• In the light of experience the database system for recording client information is being reviewed to enable easier access to information.

• Activity Report:-

New Admissions

Month	Self funders	Social Service	Out of Area
April	10	22	3
May	3	2	1
June	3	10	4
July	7	7	0
August	3	9	0
September	7	19	0
Banding for New Admissions
Low	2	0	1
Medium	19	57	4
High	12	15	3

Discharges

Month	Self funders	Social Service	Out of Area
April - September	12	9	0

Deaths

Month	Self funders	Social Service	Out of Area
April - September	17	53	4

• Continence Product Expenditure

The implementation of the new supply service to nursing homes has gone smoothly. There are some issues raised by some homes, these are being addressed.

• The appointment of an E grade nurse to work with the homes has been very successful, and the initial expenditure by homes has reduced to a more constant level. This could be attributed to the input by this nurse. Monitoring of the budget is overseen by the Continence Service Manager.

• Activity report- Total number of patients receiving supplies: 236

Month	Expenditure
April	£9,312
May	£7,831
June	£6,209
July	£5,965
August	£5,822
September	£6,708
Total	£41,845

• Pooled Budget Monitoring

The Free Nursing Care Pooled Budget monitoring report for the period from 1 April 2003 to 30^th September 2003 indicates a projected underspend at the year-end of approximately £688,000.

• This underspend is to be shared between the two organisations based on the respective contributions made to the pool. Based on the projected underspend amount, Social Services would receive approximately £525,000 and the Primary Care Trust would receive approximately £163,000.

• The underspend has accrued largely because the budget is constructed on a bed occupancy rate of 100%