Le Seelleur Charitable Trust Fund: Transfer to fund Palliative Care Services and the purchase of defibrillators

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A decision made on 29 June 2020

Decision Reference: MD-HSS-2020-0042
Decision Summary Title:	Transfer from Le Seelleur Fund to fund non-recurring palliative care services and the purchase of defibrillators		Date of Decision Summary:15th May	3rd June 2020
Decision Summary Author:	Head of Finance Business Partnering (Hospital)		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title:	Transfer from Le Seelleur Fund for palliative care services and the purchase of defibrillators.		Date of Written Report:	3rd June 2020
Written Report Author:	Head of Finance Business Partnering (Hospital)		Written Report : Public or Exempt?	Public
Subject: Use of Le Seelleur Charitable Trust Fund to fund Palliative Care Services and the purchase of defibrillators The Ministerial Decision is seeking the proposed distribution of £1.020m from Le Seelleur Charitable Trust Fund to the Health and Community Services (HCS) revenue head of expenditure in 2020; Under the proposition P.71/97 adopted by the States on 2nd June 1997, it was decided that the administration of the Estate of H.E. Le Seelleur should be carried out by the Minister for Health and Social Services (formerly known as the Health and Social Services Committee). Purpose of the spending The funding would be used for the following purposes. To fund an increase to the commissioning of palliative care services from Jersey Hospice Care by HCS. The purchase of 34 defibrillators and 2 Automated External Defibrillators (AEDs) (portable defibrillators), to replace equipment originally purchased in 2010 and now in need of renewal. The benefits of this expenditure will be a reduction in the risk of equipment failure and having an up to date model used across the hospital, which will enable a train the trainer model to be possible.
Decision(s): The Minister approved the distribution of £1.020m non-recurrent funding from Le Seelleur Fund, to be transferred to the HCS revenue head of expenditure in 2020 in respect of: Supporting the 2020 cost of the increase to the Service Level Agreement between HCS and Jersey Hospice Care for the provision of specialist palliative care services (£0.8m) Purchase of 34 defibrillators, 2 AEDs and associated equipment (£0.22m)
Reason(s) for Decision: The transfer of £1.020m from Le Seelleur Fund aligns with the purpose of the charitable trust fund, which is: “for the benefit of the aged infirm and needy residents”.
Resource Implications: The HCS revenue head of expenditure will increase by £1.020m. The balance on Le Seelleur Fund will reduce by £1.020m.
Action required: Authorisation will be sought from the Minister for Treasury & Resources to use the transferred income against the JHC contract in accordance with Article 21 of the Public Finances (Jersey) Law 2019. A Treasury decision will be obtained to facilitate the drawdown of £1.020m from the Common Investment Fund.
Signature:		Position: Deputy Richard Renouf Minister for Health & Social Services
Date Signed:		Date of Decision:

Le Seelleur Charitable Trust Fund: Transfer to fund Palliative Care Services and the purchase of defibrillators

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Health & Community Services

Ministerial Decision Supporting Report

TRANSFER FROM THE LE SEELLEUR Charitable Fund to HCs revenue account

to support palliative care services and the purchase of defibrillators

Purpose of Report

To request a distribution of £1.020m from Le Seelleur Fund to the Health and Community Services (HCS) revenue head of expenditure in 2020 to meet the costs of;

To fund an increase to the commissioning of palliative care services from Jersey Hospice Care by HCS through the monthly contractual payments. Services are commissioned via a Service Level Agreement. This funding from the charitable fund would be on a non-recurrent basis. Although the recurrent increase to the Service Level Agreement with the Hospice will need to be planned for in HCS financial plans relating to 2021. The need for the increase has been due to significant growth in patient care numbers over the last few years. The funding will help to ensure that JHC will continue to be able to offer palliative care services in 2020 without diminution of service. Patients will continue to be cared for consistently in their preferred place of care, with advanced care planning, palliative care support, and system-wide expertise in end of life care.
The purchase of 34 defibrillators and 2 Automated External Defibrillators (AEDs) (portable devices), to replace equipment originally purchased in 2010 and now in need of renewal. The benefits of this expenditure will be a reduction in the risk of equipment failure, having an up to date model used across the hospital, which will enable a train the trainer model to be possible.

Background

2.1 Jersey Hospice Care Agreement

Jersey Hospice Care provides End of Life services to HCS under a service level agreement which is renewed annually. The Hospice service includes care planning, palliative care support, and specialist support for end of life care. Since 2014 the service model has been enhanced which has led to an ongoing increase in the activity of the hospice.

In 2014 JHC extended its service provision to provide community specialist palliative care to adult patients with life limiting illness.
In 2018, following discussions with HCS, JHC extended the community specialist care provision to children and young people with life limiting and life-threatening illnesses and to offer support to their families.

Despite the above growth, the value of the service level agreement between HCS and JHC has remained unchanged since 2014.

Since 2013 there has been a 205% increase in the number of cancer patents cared for. This has resulted in a reduction in the number of patients whose death has taken place whilst in hospital. This reduction equates to 4,500 bed days, which has provided additional capacity for acute care and more importantly opportunity for the preferred place of death to be other than in a-hospital setting.

JHC have advised that their reliance upon fund raising to be sustainable is affecting their ability to provide services at the levels required and have therefore requested additional funding for existing services to continue. HCS have entered into a new agreement with JHC with an increase in funding of £0.8m in 2020 (from £0.5m to £1.3m) which will ensure that JHC can continue to provide its specialist palliative care provision without diminution of service in 2020. This increased cost will be paid within the monthly contract payments.

Under the Government Plan 2020 – 2023 there is no specific additional funding relating to the services commissioned by HCS from third sector organizations, these are key provider partners and will be essential to the delivery of the proposed Jersey Care Model. As such, it is requested that the 2020 increase in cost equating to £0.8m is met from a non-recurrent contribution from Le Seelleur Charitable Trust Fund this accords with the purpose of the fund as set out in paragraph 3.

2.2 Defibrillators

The existing defibrillators were purchased in 2010 and were due for replacement in 2019, unfortunately the capital equipment budget was unable to fund the defibrillators in 2019 or in 2020. Defibrillators are used in emergency medicine. It uses an electrical shock to reset the electrical state of the heart. It is vital that the equipment is available when undertaking CPR and is essential equipment for the crash team(s). The existing equipment is now obsolete, and the availability of new parts is becoming difficult to source.

There are considerable benefits in terms of patient care, the immediate availability when required of the equipment can reduce the risk of life-threatening arrhythmia resulting in the return of a productive heart rhythm. Having the same equipment across all locations enables train the trainer methodology to be used. This methodology refers to a person who has been trained to use the equipment, who then goes on to train other staff. This is made easier when purchasing the same equipment as all training relates to that one piece. It also means that this reduces the requirement for recurrent revenue to fund training from external parties. Having the same equipment can also facilitate equipment to be swapped out according to priority when required.

The cost for 34 defibrillators and associated AED’s is £0.22m, it is requested that the cost is met from a non-recurrent contribution from Le Seelleur Charitable Trust Fund, this accords with the purpose of the fund as set out in paragraph 3. The cost of consumables and servicing will be met on a recurrent basis by HCS

3. Background and Purpose of The Le Seelleur Fund

Harold Ernest Le Seelleur bequeathed assets to the States of Jersey for itself and its successors in perpetuity, for the following purpose - “for the benefit of the aged, infirm and needy residents of the Island”.

The acceptance of the bequest by the States was expressed in the terms of proposition P.71/97 of the Health and Social Services Committee, adopted by the States on 2nd June 1997. Under the proposition it was decided that the administration of the Estate of H.E. Le Seelleur should be carried out by the Minister for Health and Social Services (formerly known as the Health and Social Services Committee).

The assets originally settled into the Estate of H.E. Le Seelleur comprised of Jersey located property. These properties have been let to both private tenants and to staff members. Rental income has accumulated in the Fund and has been used to carry out maintenance and refurbishment works to the properties. On 8 May 2014 the Minister for HCS adopted a Property Strategy which recommended the sale of several of the properties and requested that the Treasurer invest the non-property (cash) assets of the fund in the Common Investment Fund (MD-HSS-2014-0015).

Proceeds of £4.655 million from the property sales were attributed to Le Seelleur Fund.

3.1 Fund Balance

The balance of Le Seelleur Fund including the value of property as at 31 December 2019 is £9.59m of which £2.1m is held through property ownership, £22k is held in the bank, the remainder is held in the common investment fund.

Although the Will made no differentiation between whether distributions should be made from capital or income of the fund until a reserves policy is adopted grants will be made with due regard to the reduction of the fund capital sum. (Including this grant of £1.022m the fund will have seen a net reduction of £0.655m over a 3-year period)

It is proposed that £1.020m of the fund is transferred to the HCS revenue head of expenditure to fund the two transactions set out in this report.

Approval of the use of Le Seelleur Charitable Trust Fund

This has been proposed by the Director General of Health and Community Services. A Charitable Trust Fund committee is being set up to provide suitable governance in the future for such decisions, in the absence of this committee being in place with delegated authority a Ministerial Decision is being sought.

The Minister for Health and Social Services approved the distribution of £1.020m non-recurrent funding from Le Seelleur Fund, to be transferred to the HCS revenue head of expenditure in 2020 in respect of:

• Supporting the 2020 cost of the increase to the Service Level Agreement between HCS and Jersey Hospice Care for the provision of specialist palliative care services (£0.8m).

• Purchase of 34 defibrillators and associated equipment (£0.22m)

Use of Le Seelleur Charitable Trust Fund is in accordance with the terms of the Fund the original bequest being given to the States of Jersey for itself and its successors in perpetuity, to be used - “for the benefit of the aged, infirm and needy residents of the Island”.

Recommendation

The Minister is recommended to approve the distribution of £1.020m from Le Seelleur Fund, to be transferred on a non-recurrent basis to the HCS revenue head of expenditure in 2020.

Following approval of the recommendation the following will take place;

Authorisation will also be sought from the Minister for Treasury & Resources to use the transferred income against the JHC contract in accordance with Article 21 of the Public Finances (Jersey) Law 2019.
A Treasurer Decision will be obtained to facilitate the drawdown of £1.020m from the Common Investment Fund.

Reason for Decision

Approval of grants made from Le Seelleur Fund are required to be approved by the Minister of Health and Social Services

Article 21 of the Public Finances (Jersey) Law 2019 states that where a States body or area of operation will earn income more than that estimated in an approved government plan during that financial year, the Minister may direct that the excess income be allocated to a head of expenditure set out in the plan.

7. Resource Implications

The balance of funds on Le Seelleur Fund will reduce from £9.59m by £1.020 m to £8.57m

The revenue budget head of expenditure available for HCS will increase by £1.020m this will equate to the expenditure incurred in accordance with this fund distribution request.

	Name and Signature
Report author -Head of Finance Business Partnering (HOSPITAL)	Jo Larkin	Document date 3rd June 2020
Quality Assurance / Review: Group Director	Steven Mair	File name and path:
Director General sponsor:	Caroline Landon	File name and path: