Agenda item

The Cabinet Member for Health, Social Care, and Wellbeing considered the report which sought agreement to vary the pricing of two contracts with MagiCare Limited for the provision of Nursing Intermediate Beds at Priscilla Wakefield House.

One was an 8-bed contract funded by the Clinical Commissioning Group (CCG) Better Care Fund (BCF) Minimum Allocation, and the other was a 10-bed contract funded from the Improved Better Care Fund (iBCF). Operationally we utilise the 18 beds flexibly as a joint Health and Social Care initiative to help people recover.

The variation requested was to allow an inflationary increase in the weekly bed rate:

8 bed contract: from £1,032 to a new base rate of £1,105, with an additional temporary uplift for 2022/23 only to £1,200.

10 bed contract: from £1,036 to a new base rate of £1,078, with an additional temporary uplift for 2022/23 only to £1,200.

At a total additional cost of £408,778 over the remaining lifetime of the contracts.

The variation was allowed under CSO10.02.1(b) (variations and extensions valued at £500,000 and above to be taken by Cabinet) and CSO16.02, which provided that in-between meetings of the Cabinet the Leader take any such decision that would normally be taken by Cabinet or may allocate this to the Cabinet Member with the relevant portfolio.

The 10-bed contract was awarded by Cabinet in August 2019 for an initial period of eight years. The 8-beds contract was directly awarded by Cabinet in February 2022 for an initial period of three years.

The Cabinet Member asked about the additional temporary uplift and how this would be addressed in future years. The Commissioning Officer explained that the new base rate was made within available uplifts to the BCF and iBCF. The temporary uplift for 2022/23 would sustain the provider whilst the council and the Integrated Care Board (ICB) reviewed its funding as part of the overall North Central London (NCL) Intermediate Care Bed Review during 2022/23. The provider had been informed that the Council could not commit to additional funding for future years at this stage but that negotiations would start from this base rate.

The Cabinet Member RESOLVED

1.    Pursuant to CSO 10.02.1b and CSO 16.02, to approve the variation in price of the existing block contracts awarded to MagiCare Limited for the provision of 18 (10 + 8) nursing intermediate beds at Priscilla Wakefield House, to a new base rate.

2.    To temporarily increase, for 2022/23 only, the nursing intermediate bed price from the new base rates, £1078 and £1105 respectively, to £1200 per week for all 18 beds from the 1 April 2022, bringing the remaining contract value over the maximum life of the contracts from £5,916,779 to £6,325,557. The total addition cost of the variation over the remaining lifetime of the contracts is £408,778 (£216,903 for the 10-bed contract and £191,875 for the 8-bed contract).

3.    To approve the variation of the existing contracts at the costs set out in paragraph 3.2 of the report (resolution 2).

Reasons for decision

There is a paucity of nursing home provision within the borough with only one CQC registered nursing homes. The award of both existing contracts with MagiCare Limited has enabled us to continue working with a local provider to deliver intermediate care nursing bed service in Haringey.

The existing contracts do not provide for any inflationary increase for the first three years of the contract; therefore all costs were deemed to reflect the price for the relevant Contract Year and the price was held from the contract commence date.

However, an uplift is required sooner to sustain the provider through high levels of inflationary pressures and increasing staff costs experienced by this provider which are similar to those experienced by the rest of the care home sector.  The new base rate is made within available uplifts to the BCF and iBCF. The temporary uplift for 2022/23 will sustain the provider whilst the council and the Integrated Care Board (ICB) review its funding as part of the overall North Central London (NCL) Intermediate Care Bed Review during 2022/23.

Increasing the value of the contracts will secure access to local provision for older people and maintain much needed nursing intermediate care capacity within the sub-region. It will also maintain certainty over price, securing sustainable prices for placements for Haringey residents.

Alternative options considered

Do nothing – there is a high likelihood that the provider would service notice on these contracts. This would result in sole reliance on spot purchasing for the provision of these beds. Due to the limited availability of nursing bed provision within the borough this would likely lead to out of borough provision, delays to discharge and the loss of the benefits of rehabilitative input from the Multi-Disciplinary Team (MD)T and Care Home Assessment Team (CHAT).

Go out to tender – As Priscilla Wakefield House is the only nursing home in the borough it would have been necessary to obtain bids from nursing homes outside the borough. Due to the multi-disciplinary support already in place at PWH out of borough provision would result in the loss of the benefits of rehabilitative input from the MDT and CHAT and diminish the effectiveness and value of the service.

Across the North Central London Sustainability and Transformation Plan footprint there is limited provision of nursing care. Currently there are approximately 2500 nursing home beds within the five partner boroughs. It is Haringey’s policy to only place residents in homes which are rated ‘Good’ and ‘Outstanding’ by CQC -28% of beds within the STP footprint are in establishments rated ‘requires improvement’ which further limits the number of available supply.