Too much change, too soon - Scrutiny verdict on nursing changes

Monday 27 February 2017

Changes were brought in too quickly, negotiations were too slow, and there was little clarity on key financial information - those are the main conclusions of a report into major changes to way home care is delivered in Jersey.

The Health Scrutiny Panel has been checking plans to cut the funding to Family Nursing and Home Care, something the charity says will have a knock-on effect for both its 118 staff and the islanders it cares for.

In September, it emerged that the Health Department was planning to withdraw funding for home care services.

They are provided by Family Nursing and Home Care (FNHC), who said that the decision to cut the funding would mean their charges would have to increase from £11 per hour to around £19 per hour. It also led them to make the jobs of 118 staff 'potentially at risk', while they renegotiate their contracts. Those unable to accept the new contracts, which will leave them worse off, will face redundancy.

FNHC receives around £7.5million a year from Health to provide a variety of nursing care services to islanders in the community. 

Currently, part of that money covers home care services - such as help with dressing, helping with medication, bathing, getting out of bed or going to the toilet - for 214 vulnerable or disabled islanders in their own home. 

Health later said it would delay bringing in the funding cut - a decision that has been welcomed today by the Health Scrutiny Panel. 

In its report, it says: “Due to the complex nature of how the funding was allocated, it has been difficult for both sides to agree on how much of the block grant is allocated to home care. Negotiations on this matter had been ongoing for a year, with little evidence to show agreement had been reached on how the funding was apportioned. This has proven to be a sticking point which has protracted this situation. The Panel recommend that the Health and Social Services Department confirm how the funding is apportioned as a matter of urgency.”

The panel’s second finding is: “Negotiations for the removal of the subsidy were slow, with long gaps. Both [sides] bear responsibility for this. Health and Social Services failed to clearly communicate its change in position to FNHC and then attempted to make changes in a short timeframe. On the part of FNHC there was a seeming reluctance to accept and engage with the changes. This failure to agree led to FNHC’s announcement in September 2016 with regards to their staff terms and conditions.”

Summing up, the Chairman of the Panel, Deputy Richard Renouf, says: “The Panel has found that there was little clarity over how the funding was apportioned for home care services, which in turn has led to this situation. The Health and Social Services Department have attempted to make too many changes in a short space of time without viable alternatives in place and it is appropriate therefore that the Minister for Health and Social Services has extended the funding until January 2018 to allow for a more orderly transition.”