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Decision details

Approval for provision of 20 discharge to assess/community flow beds by way of an exemption to extend

Decision Maker: Helen Jones (Director - Joint Commissioning)

Decision status: Recommendations Approved

Is Key decision?: No

Is subject to call in?: No


To approve the repurposing of the existing Intensive Rehabilitation and Delirium at Little Manor Nursing Home beds provision to Hospital Discharge Support Units (HDSU) to support customers urgent discharge from hospital due to the Covid-19 crisis.

The total value for a maximum of 26 weeks commencing on the 20.01.2021 is anticipated to be £1,170,000.00. This is a maximum contract and it is envisaged that the service will revert to normal as soon as the current emergency eases (the contract will contain a 4-week notice period so that we can be responsive to changing needs). Please see appendix 1 for details of the contracts.

To allow the Strategic Procurement Hub to enter into the resulting contracts in line with the Council’s Constitution and Schemes of Delegation, including the use of e­ signatures where permitted and considered appropriate.

Reasons for the decision:

There is an urgent need to secure additional in a care home setting because:

a. The UK is experiencing a pandemic outbreak of the COVID–19 virus.

b. Due to commencement of second wave of COVID 19, which has entered a serious phase under the second wave due to variant Covid strains. Although the second wave was anticipated the significant increase in cases, which continues to rise, could not be anticipated. The consequences of the increased cases are not something that could have been predicted.

c. Wiltshire requires capacity to support the discharge of people from acute and community hospitals. In order to create this capacity, the council have been requested to commission additional nursing care provision to facilitate earlier discharge from the community hospital, to create and maintain flow for the whole system (acute hospitals, community hospitals and supporting services)

d. The provision of these services will mean that customers can be supported in a nursing environment (who have not tested positive for Covid – 19) following discharge from an NHS Hospital. This will help support the health system by releasing beds in NHS hospitals for those in greater need of specialist healthcare support.

e. A block contract agreement for additional nursing bed capacity will mean that customers can be discharged quickly, without delay, compared to alternative commissioning arrangements. This therefore provides more responsive capacity needed to support such discharges.

f. The funding for this provision will be provided via the Hospital Discharge Fund (HDF), which in turn means the cost of this provision is met by the NHS.

I confirm that in making this decision I have considered the following in line with Wiltshire Council’s Constitution:

Key decision requirements: Yes

Views of relevant cabinet member(s), committee chairman, area board(s): Leader and Cabinet Member have been appraised

Consideration of the area boards and delegated decision checklist for officers on the issue of when and how to involve local councillors and area boards in decisions about local services: Not applicable

Implication of any council policy, initiative, strategy or procedure: Yes

Consultation in accordance with the council's consultation strategy: Not applicable

Range of options available: Yes

Staffing, financial and legal implications:Yes

Evidence of due regard having been given to the Public Sector Equality Duty: Yes. This will principally benefit elderly people and others from vulnerable groups.

Risk assessment: Yes

Involvement of statutory officers and/or directors: yes

Regional or national guidance from other bodies: Not applicable

The council’s constitution: Yes

This contract is suitable for execution under the e-signature process: yes

Alternative options considered:

Given the extreme urgency, no other options were considered.

Conflict of Interest: Not applicable

Background: As the Director for Commissioning, I am responsible for any matters relating to Domiciliary Care in the County of Wiltshire on behalf of Wiltshire Council. The power to make a decision in respect of this matter is delegated to me pursuant to Wiltshire Council’s Constitution. In any event, pursuant to paragraph 4 of Part 3 Section D, the Directors of Wiltshire Council are is empowered to take all necessary decisions in cases of emergency where the Director concerned believes that there is a risk of damage to property, a threat to the health or wellbeing of an individual and/or that the interests of the Council may be compromised if this decision is not otherwise taken. Currently, the UK is experiencing a pandemic outbreak of the COVID–19 virus. A direct impact of this is the necessity for Wiltshire Council to make rapid decisions to secure the health & wellbeing of the Community and to support the wider Health and Social Care System These repurposed services are being procured und

Contact: Helen Jones, Director - Joint Commissioning Direct Email: helen.jones@wiltshire.gov.uk.

Publication date: 24/02/2021

Date of decision: 19/01/2021

Accompanying Documents:




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