Agenda item

To receive a report on the Better Care Fund from Sue Lock, Managing Director, Leicester City Clinical Commissioning Group.

The Board are requested to approve the draft BCF 16/17 template for submission on February 8^th 2016 and to delegate approval of draft narrative plans to the Chair of the JICB and the Strategic Director for Adult Social Care for submission on February 8^th 2016.

The Board received a report on the Better Care Fund (BCF) from Sue Lock, Managing Director, Leicester City Clinical Commissioning Group.

The Board were requested to approve the draft BCF 2016/17 template for submission on February 8th 2016 and to delegate approval of draft narrative plans to the Chair of the JICB and the Strategic Director for Adult Social Care also for submission on February 8th 2016.

It was noted that the format of the template was not an ideal way of presenting the information but it was a prescribed national format.  The template required approval each year as it was a joint plan.  The submission was in two parts, one is the template currently being considered and the second part is a narrative plan which sets out how the joint partners will achieve the trajectories.  This could not been completed until national guidance had been received.

Part 1 of the template showed Better Care Fund expenditure of approximately £22m and represented, at service line level, what the CCG and the Council believed would be the most effective way to integrate services aimed at preventing emergency admissions.  This was based upon the successes of the previous year with an element of expansion in some of those.

There was a high level classification of whether elements were Integrated Care Teams, Support for Carers or Reablement Services etc. with expected expenditure against each one.  There was approximately £190k of recurrent expenditure that would be re-prioritised through the year.  In addition there was a £1m none recurrent carry forward and proposals had been invited for this.

In response to a question on the £1.9m expenditure on the Performance Fund, it was noted that this was an amount of the fund that was payable based upon the performance to reduce none elective emergency admissions.  It was a retrospective payment at the year end.  If the performance did not achieve the intended reductions, the payment went to the acute trust.  If the performance was achieved and the reduced admissions targets were achieved; then the payment was paid into the Better Care Fund in the following year.

It was noted that in putting forward the current proposals, horizon scanning had been carried out to evaluate what had been carried out elsewhere in the country.  Experience of local and national events showed evidence that local practice was effective and robust and this had been mirrored in feedback at national level.  Furthermore, the City’s BCF had been cited as an example of good practice to other bodies including a presentation at the House of Lords.

The Director of Public Health commented that the risk stratification work undertaken for the BCF had potential to be used to great effect outside of the BCF context to consider the benefits that could be achieved through limited resources in preventative initiatives.

The East Midlands Better Care Fund Implementation Manager, NHS England, commented that the City’s BCF was considerably further advanced with its financial information than other Health and Wellbeing Board areas covered by her post.  It had been confirmed that the narrative plan would only be considered at a regional level rather than national level as in previous years.  There was no prescribed template for the plan and it would focus on looking at what had worked well in the previous year, what hadn’t and what had steps had been taken as a result.  It was noted that the lack of national guidance had impacted upon the timetable in relation for the requirement to produce the narrative plan.  However, no changes were expected to the current guidance except for changes in relation to the delayed transfer of care and non-elective admissions.  The provision of the Performance Fund in the current draft BCF was commended as recognising these as issues.

The BCF Implementation Manager also stated that she could share a dashboard indicator of the 10 Health and Wellbeing Board areas within her remit which confirmed that the City was currently performing the best. 

The Chair welcomed the offer of sharing the dashboard indicators with the Board.  He felt that whilst the current draft had been commended for its planning, it was important to avoid being complacent in view of the fragility of future spending and budget allocations especially in relation to forthcoming spending reviews.

RESOLVED:

1)         That the draft BCF 2016/17 template for submission on February 8th 2016 be approved and that approval of draft narrative plans also for submission on February 8th 2016 be delegated to the Chair of the JICB and the Strategic Director for Adult Social Care.

2)         That NHS England and the Department of Health be made aware of the Board’s views that:-

a)         the current presentation of information in the template was not helpful to people who had an interest in the topic but did not have a heath background.

b)         a number of schemes and interventions related to more than one scheme type and the true picture was distorted because of the inflexibility of having to badge each scheme and intervention against only one scheme type.