Agenda item

Purpose: To review the organisational response to the changes in the provision of social care and community equipment implemented in July 2025, and to consider the measures being put in place to ensure the effective and sustainable delivery of equipment services going forward.

Melanie O’Rourke (Service Director, Adult Social Care) presented the report on the provision of community equipment, focusing on the challenges faced following the insolvency of the previous provider, NRS, and the transition to a new provider, Millbrook. The presentation highlighted the challenges faced, the measures taken to ensure continuity of service, and the lessons learned to improve future resilience. The council’s priority during the crisis was to ensure the delivery of critical equipment to support hospital discharges, avoid hospital admissions, and provide end-of-life care.

During the debate the following points were discussed:

·         It was raised that the council should regularly review the credit status of contractors to prevent similar issues in the future. Melanie O’Rourke confirmed that this would be incorporated into future commissioning practices to ensure early identification of financial risks.

·         A question was asked about the maintenance of equipment and whether the new provider, Millbrook, was in a position to handle this responsibility. Melanie O’Rourke explained that Millbrook was prioritising high-risk equipment maintenance in compliance with regulations. She added that all servicing was expected to be completed by June 2026, with regular monitoring in place to ensure safety.

·         Concern was expressed about the lack of support from the Department of Health and Social Care (DHSC) during the crisis. It was noted that the DHSC did not intervene to provide financial assistance or extend the operational period of NRS, which could have allowed for a smoother transition. Melanie O’Rourke confirmed that feedback on this issue was being provided through national resilience debrief sessions.

·         It was discussed how NRS accumulated a £20 million funding gap and whether government intervention was needed to prevent such failures in essential services. Melanie O’Rourke highlighted that the limited number of providers nationally posed significant risks, with only two major providers now operating in the market. She noted that this issue was being reviewed by the Association of Directors of Adult Social Services (ADASS) to explore future commissioning strategies.

·         A question was raised about ownership and timelines for the action plan to address the lessons learned from the crisis. Melanie O’Rourke explained that Paul Coe, as Executive Director, is leading the commissioning work. She added that regular meetings with key stakeholders are transitioning into a business-as-usual model, with clear actions and timelines being incorporated into the commissioning arrangements.

·         It was queried whether Millbrook’s pricing was significantly different from NRS and whether the overall cost of the service is expected to rise. Melanie O’Rourke explained that Millbrook’s pricing reflects the true cost of providing a sustainable service. She noted that prescribing practices have changed, with a focus on avoiding over-prescription of equipment while ensuring that individuals’ needs are met. This approach is expected to balance costs over time.

·         A question was asked about how the council managed communication with clients during the crisis and whether the delays had any severe health impacts. Melanie O’Rourke acknowledged that communication was challenging due to the sensitivity of the situation. She emphasised that the council prioritised critical cases, such as hospital discharges, end-of-life care, and avoiding hospital admissions, to minimise adverse impacts. While some hospital discharges were delayed, there were no reported deaths directly attributable to the crisis.

·         It was noted that the crisis required significant additional work from council staff, with a core group of approximately six individuals working full-time on the issue, supported by other teams such as transport services. Melanie O’Rourke confirmed that this had an impact on the wider service, as other duties had to be redistributed to maintain operations.

·         Comments were made commending the council’s adult social care team for their collaborative efforts and rapid response during the crisis. It was noted that the council’s approach compared favourably to neighbouring authorities, some of which received complaints about their handling of the situation.

·         It was discussed whether the council had quantified the health impacts of the crisis, such as the effects of delayed equipment delivery on clients’ recovery or quality of life. Melanie O’Rourke explained that while there was no formal analysis of physical impacts, the council worked closely with acute trusts to mitigate delays and prioritise critical cases.

·         It was asked whether the council had received any complaints from clients during the crisis. Melanie O’Rourke confirmed that there were no significant complaints, which she attributed to the council’s proactive measures and the collaborative efforts of staff and partners.

·         A comment was made about the importance of learning from the crisis to improve future resilience. Melanie O’Rourke highlighted that the council had already implemented changes, such as improved oversight of contractors and closer collaboration with partners, to strengthen the service.