Agenda item

To be presented by Tracey Ironmonger, Interim Service Director for Integrated Commissioning.

The purpose of the report is to provide Health and Wellbeing Board (HWB) with an update on the Better Care Fund for 2020-21.

Recommendations:

•       To note the Better Care Fund budget for 2020-21.

•       To delegate authority for approval of the 2020-21 plan, including locally set metrics, to lead officers for BC Integrated Commissioning and Buckinghamshire CCG.

•       To delegate authority for allocation of expenditure for 2020-21 to lead officers for BC Integrated Commissioning and Buckinghamshire CCG.

•       To approve that the Integrated Commissioning Team continue to service the requirements of the BCF nationally and locally, including regular reporting via the Integrated Commissioning Executive Team on performance and bi-annual updates to Health and Wellbeing Board.

•       To note the current position in relation to Better Care Fund and performance.

Tracey Ironmonger, Interim Service Director, Integrated Commissioning, provided a presentation (slides 43-48 of the presentation appended to the minutes).  T Ironmonger explained that the Better Care Fund (BCF) was introduced in 2013 and the purpose was to improve the integration between health and social care services to help people manage their own health and live independently.  The funding supports integration between the Clinical Commissioning Groups (CCGs) and local authorities through a pooled budget and agreed integrated spending plan.

Confirmation of the funding allocation for this financial year had been received but the 20/21 plan, which sets priorities and direction of had been delayed.  T Ironmonger provided an overview of the three financial components:

• Minimum CCG contribution – approximately £32 million (£10.6 million mandated for Adult Social Care).
• Improved Better Care Fund (iBCF - which now incorporated Winter Pressures Grant).
• Disabled Facilities Grant (DFG).

BCF planning guidance was expected to be published this year; 20/21 would be a transition year as the BCF was expected to move to a three year cycle which would be beneficial for planning purposes.  As per national guidance the funding in 20/21 has been allocated based on previous spend and includes projects such as  seven day working, both from the hospital discharge management side and from an adult social care placements side, so that discharges were managed effectively throughout the week.  It also provided assistive technology to help people to stay independent at home.  Specific projects had been put in place e.g. home from hospital and an Integrated Carers Service. 

The high impact change model was designed nationally to support system partners to improve health and minimise unnecessary hospital stays.  There were five levels of maturity ranging from ‘not acceptable’ to ‘established’ to ‘exemplary’.  Slide 46 showed the nine elements which had all been rated as ‘established’ meaning standard processes were in place but were still subject to improvement.  T Ironmonger highlighted ‘housing and related services’ which was a new domain, partly to reflect some of the disabled facilities grant being part of the BCF funding but also to reflect the importance of housing and safe access to safe accommodation as a key part of people's health.

It was expected that the post Covid-19 learning around discharges would be incorporated into the new guidance.  There had been no formal monitoring and no local targets had been set due to the pandemic but the service was conscious of the importance of monitoring and use of the data to make improvements to the system when the targets were set.

The following points were raised in discussion:

• In response to being asked if there was a pathway/aim to move the domains to ‘exemplary’; T Ironmonger stated that all the domains were critical and there was an aspiration to improve on them all.
• A query was raised on whether the Disabled Facilities Grant funding was being spent due to the changes in becoming a unitary council.  Isobel Darby, Cabinet Member for Housing and Homelessness, stated that there was now an Occupational Therapist working within the housing team and it was working well because the assessments/adaptations needed to be completed within a specified timeframe and were being carried out much more quickly with staff members working together in one team.

RESOLVED:  The Members of the Health and Wellbeing Board AGREED:

•       To NOTE the Better Care Fund budget for 2020-21.

•       To DELEGATE authority for approval of the 2020-21 plan, including locally set metrics, to lead officers for BC Integrated Commissioning and Buckinghamshire CCG.

•       To DELEGATE authority for allocation of expenditure for 2020-21 to lead officers for BC Integrated Commissioning and Buckinghamshire CCG.

•       To APPROVE that the Integrated Commissioning Team continue to service the requirements of the BCF nationally and locally, including regular reporting via the Integrated Commissioning Executive Team on performance and bi-annual updates to Health and Wellbeing Board.

•       To NOTE the current position in relation to Better Care Fund and performance.