Re-ablement

1. 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