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Improved Reporting of Adult Social Care Finance and Activity Data Revisions to PSS EX1 return

Improved Reporting of Adult Social Care Finance and Activity Data Revisions to PSS EX1 return. Presenter: Nick Miller Feedback to pssex1@dh.gsi.gov.uk – closing date October 20 th. Outline of presentation/discussion. Background Objectives / principles Timescales

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Improved Reporting of Adult Social Care Finance and Activity Data Revisions to PSS EX1 return

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  1. Improved Reporting of Adult Social Care Finance and Activity DataRevisions to PSS EX1 return Presenter: Nick Miller Feedback to pssex1@dh.gsi.gov.uk – closing date October 20th.

  2. Outline of presentation/discussion • Background • Objectives / principles • Timescales • Proposals with issues for consultation • Personalisation and low level intervention • Next steps • Details of memorandum lines Full report at : csed.csip.org.uk or on IC website under PSSEX1.

  3. PSSEX1 history : Introduced 2001-02 Link to CIPFA actuals , RO and RA forms Joint IPF/DH (now IC) BVACOP and SEA For variety of users A commissioning focus PSSEX1 provides: Actuals incl overheads By 4 main client groups 11 subdivisions Gross (LA own, external) Net (income from different sources) Background

  4. Timing and use To IC mid July At LA level in public domain in February (provisional LA data October 2008) Cost to LAs of collation LAs internal use limited – link to activity data weak – no view of packages of care LAs benchmarking use Central users – DH, Audit Commission, CSCI etc Content Policy issues not covered – Objectives of spend and outcomes (e.g. rehabilitation) Personalisation Low level services Client groups missing dementia/ carers.. Alternatives to long term care in care homes … Comparability problems across time and councils PSSEX1 issues

  5. Principles guiding proposals • Benefit for councils – data more relevant and useable for management • Burden low – value high • Earlier availability of data from centre • Maintain time series & requirements of DH, CLG, AC • Keep in line with BVACOP • Contribute to JSNA/ joint commissioning To ensure secure delivery: • Authoritative central point for queries / guidance • Link to other central returns and NASCIS • Future-proof – Green Paper.. • Training

  6. Outline of proposals • ‘New’ client groups memorandum lines – OPMHN, OPLD, Carers • Memorandum items for expenditure – ‘of which…’ – some with purpose of spend (e.g. rehabilitation) • Parallel activity measures where possible • Reporting on support service / SSMSS ‘overheads’ – development of central allocation across expenditure • New measures from data of relevance to policy (Annex G) • Work on linking activity and spend data at client level - and adding in quality and outcomes. Finance and activity returns to centre extracted from this local management tool. (See separate slides)

  7. Proposed timescales (1) • 2008-09 • Disaggregation via memo lines/activity measures Voluntary: anonymous. Support services apportionment excluded/ included in memo lines • Support services costs (SSMSS) included as now • Test tool to extract data from councils’ systems • Develop outputs, including new measures • 2009-10 • Disaggregation OP/carers/sub-divisions: ? mandatory • Support services now in SSMSS to be reported as memo items but to be allocated by national formulae • Continue/ finalise work on extraction tool or councils’ own equivalent and on national report requirements

  8. Proposed timescales (2) • 2010-2011 • All councils report to new standards • All support services ‘overheads’ allocated centrally by formulae – ‘backward’ reporting possible of 2009-10 SSMSS allocation on formula basis • Data on services (for old SR1/RAP) all collated via new return… can/should care management data (referrals, assessments, reviews) also be covered? • Linkage to NHS and housing data locally • Implications for councils/ central collections / central users set out

  9. Benefits • To all from • Disaggregation within existing return • Work on system to link activity and expenditure locally – see separate presentation • New measures of spend relevant re new policy implementation • Potential to link in objective of spend, quality of service measures and outcomes…..

  10. Consultation issues • From OPMHN/ OPLD/ Carers split out? • From memorandum items within subdivisions • Are the proposed lines of sufficient importance / policy relevance; adequately specified / defined; reasonably extractable? • De minimis items? • From support services overheads to be reported and centrally pro-rata-ed? Should in-house care services be treated differently? • Can we move to national formulae for allocation of support service costs for 2009-10 or do we hold this change over to 2010-11?

  11. Self directed support • Link to IC proposals for reporting in RAP • Where user takes support as a Direct Payment, no change. • Where user opts to use IB for services which fit within current subdivisions, show as now in financial reporting. Potential in data extraction to link the client’s IB agreement to any activity or spend data – this should allow extraction for any service sub-division or client group division of amount of spend which was subject to an IB agreement • Where user opts for services arranged by council which are not within current subdivisions (e.g. personal assistant/ non-standard day activity) show in ‘other’ as now (but identify spend and activity via IB link above).

  12. ‘Low level interventions’ • ‘Strong & Prosperous Communities’ interest in wellbeing of whole population and sub groups – council and other agencies’ contribution • PSS EX1 identifies grants to voluntary sector and others • Councils will have own local knowledge of ‘low level’ services – some following assessment but often without specific details of those benefiting • ? Joint Strategic Partnership / council responsibility to collate data – may be part of LAA?

  13. Next steps • Letter to DASSs/ Treasurers from John Bolton seeking feedback by October 20 and volunteers • Use IC’s and other road-shows to seek comments/ volunteers • DH consulting with DCLG on status of PSSEX1 return in future • Following end of IC consultation, meet CIPFA PSS EX1 working party and others to review feedback and agree any changes • IC to issue new requirements and voluntary items details for 2008-09 and 2009-10 in November along with IC new returns details • Work on extraction tool and reporting from it • Agree source/content of advice and ‘training’ for councils

  14. Sub-divisions memo items (1) (Annex C – with link to detail for each at Annex J) Row 1: ASSESSMENT / CARE MANAGEMENT Of which Initial points of contact – CRM Occupational therapists engaged in assessment and care management Support staff to assessment and care management NB – all three memo lines will be reported across all client groups Rows 2 and 3: NURSING CARE / RESIDENTIAL CARE (combined) Of which: Rehabilitation / intermediate care Respite care Short term care

  15. Sub-divisions memo items (2) (Annex C – with link to detail for each at Annex J) Row 4: SUPPORTED / OTHER ACCOMMODATION (NB – where Supporting People funds are being used these should NOT be included here but continue to be reported as line 11 for each client group) Of which: Adult placement schemes – permanent residents Adult placement schemes – temporary residents Adult placement schemes – respite residents Supported living / group homes Refuges / hostels not registered with CSCI Community support services Extra care housing – accommodation element Row 5: DIRECT PAYMENTS (for all client groups together) Of which DPs to carers (to be reported as a memorandum item under the new Division for Carers) – see below Administration supporting DPs

  16. Sub-divisions memo items (3) (Annex C – with link to detail for each at Annex J) Row 6: HOME CARE Of which: Rehabilitation / re-enablement Extra care housing – personal care element Live in home care Night sitting (waking) – numbers of cases and costs may be small so may be merged with night sleeping Night sleeping - numbers of cases and costs may be small so may be merged with night sitting (waking) Day sitting

  17. Sub-divisions memo items (4) (Annex C – with link to detail for each at Annex J) Row 7: DAY CARE Of which Employment related services (excluding sheltered employment which is reported separately at line J1 under SEA rules) Row 8: EQUIPMENTAND ADAPTATIONS Of which Telecare equipment and its maintenance Prescriptions for equipment and their management costs ICES Store costs + associated transport

  18. Sub-divisions memo items (5) (Annex C – with link to detail for each at Annex J) Row 9: MEALS Of which Meals on wheels and frozen meals Lunch clubs meals Row 10: OTHER SERVICES (page 36) Of which H3 substance abuse (addictions) split into Alcohol abuse – Residential / nursing care expenditure Other services. Drugs / solvent abuse (with or without alcohol abuse) Residential / nursing care expenditure Other services.

  19. Sub-divisions memo items (6) (Annex C – with link to detail for each at Annex J) TOTAL SUPPORT SERVICES costs – all costs allocated as overheads (including corporate recharges) Of which: Client support (and specifically: – welfare benefits, advocacy, advisory services) Operations support (and specifically: – performance management, planning, contract management, commissioning, brokerage) IT Finance – excluding financial assessment Financial assessment Training Premises and property costs Transport Other support costs

  20. Examples of new measures from memorandum items (from Annex G) • Rehabilitation / intermediate care in care homes as % of total spend on care homes (excluding respite care) • Rehabilitation / re-enablement home care as % of overall home care • Supported accommodation as % of ((care home spend – respite - short term care)+ supported accommodation spend) • Direct payments spend as % of all ‘community support’ spend (including respite, short term care, rehabilitation in care homes) • Telecare spend as % of total equipment spend • Equipment ‘prescriptions’ spend/total equipment spend

  21. Examples of new measures from memorandum items (from Annex G) • Carers’ services costs (including respite care)/ total services costs • Direct payments to carers / (all carers services + respite care) • Employment related day services for each <65 group / all day services for each < 65 group • % of overall spend on home care which is committed to rehabilitation, live-in home care, night sitting/ sleeping etc • % of OPMHN expenditure committed to residential + nursing care, to community services

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