Carmarthenshire Council in dispute with health board over care funding

Carmarthenshire Council is in dispute with the region’s health board about how aftercare is funded for certain cases where people have been detained under the Mental Health Act. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

A report before the council’s health and social services scrutiny committee claimed Hywel Dda University Health Board was not “legally compliant” as it had stopped contributions in some of these cases – known as Section 117 cases – and that this created a financial risk for the council. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

The cases in question relate to people who are eligible for free aftercare – for example a residential placement – after having been detained in hospital under certain sections of the act. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

Alex Williams, the council’s head of integrated services, said the council and health board split the cost of aftercare equally for younger adults in these cases, but that the council paid for older people. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

She said this was down to different planning and commissioning arrangements on the health board’s end, but that the council was keen to pursue a 50/50 split for older people. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

“It’s something we have been pushing quite strongly on a regional basis, that we need equity for all client groups,” she said. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

Ms Williams said a regional policy setting out a 50/50 aftercare funding split for older as well as younger Section 117 cases had been proposed. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

“Unfortunately, in the end the health board took a decision to publish a health board-only policy, and the policy has stayed silent on the funding split,” she said. “So we are not really any further forward.” ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

The committee will write a letter to the health board outlining its concerns about what was said, although the number of disputed cases isn’t large. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

Head of adult social care, Avril Bracey, said: “We are not talking about lots and lots of people.” ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

In response, Jill Paterson, the health board’s director of primary care, community and long-term care, said there had been no recent change to fee arrangements with its local authority partners and that it did not recognise the statement that 50/50 was a legal requirement in the cases in question. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

“There is no specific reference within the Mental Health Act to indicate which organisation should provide funding for specific Section 117 aftercare services,” she said. ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

“However, we will continue to work with Carmarthenshire Council to ensure we can provide patients with the mental health services they need.” ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​

By BBC LDRS ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​