1. Deputy Director, Social Care Policy
Re-ablement
William Vineall,
Deputy Director, Social Care Policy
Department of Health
Social Care

2. Post-discharge tariff
Post discharge tariff announced in June, with revision to NHS Operating Framework for 10/11
In 11/12 savings accrue to commissioners for non-payment of re-admissions
In 12/13 providers responsible for patient care for 30 days after discharge
Pilots to test tariff adjustment for 30 day responsibility in 12/13 starting imminently
Social Care

3. Re-ablement Re-ablement a contributor to post-discharge tariff policy
£70m made available for re-ablement in 10/11, via PCTs, in October
PCTs asked via circular at end October to agree joint plans with LAs and voluntary sector by Christmas – how the money is spent for local determination
Further resources, £150 in 11/12, £300m12/13 onwards in PCT baselines
In addition, £648m in 11/12, rising to 1bn by 14/15 of SR funds for social care by transfer from PCT to LAs (via sec 256 of NHS Act)
Social Care

4. Re-ablement
Definition – ‘a period of active care, typically for six weeks, to promote independence, help people live at home and reduce the need for acute hospital care’
Can include a range of therapeutic/social care activities
Social Care

5. Policy challenge
Concentrates hospitals’ minds not to discharge prematurely
Where does re-ablement support best sit – in the 30 day period, afterwards, or both? Where should investment be concentrated – NHS, social care, acute/therapeutic services?
30 days is a point at which responsibility changes, but it should not be the sole focus of planning services
Social Care

6. Pilot sites for revision of tariff
Tariff revisions currently being piloted
Various approaches, including focus on patients regularly re-admitted
An opportunity for whole system to work together – hospital, GPs, community services, social care, voluntary sector
Social Care