Agenda item

Leicester City Clinical Commissioning Group to submit a report on the Leicester City Better Care Fund 2017-19.

Leicester City Clinical Commissioning Group submitted a report on the Leicester City Better Care Fund 2017-19.

It was noted that the draft was being submitted later than usual because the planning guidance and the requirement of the Better Care Fund were not issued until mid-July by NHS England and a submission date of 7 September 2017.  The draft narrative of the plan was contained in the current draft document narrative template and the final planning template had only recently been received since the Agenda was published and this was being completed.  Guidance was being drip fed to the CCG by NHS England and the Final Key Lines of Enquiry had only been received from NHS England earlier in the week and work was progressing to complete these.  The Plan, therefore, may change to reflect any additional information requested by NHS England before the formal submission date.  

The current draft had been prepared jointly by the CCG, the Council, partner organisations including UHL and LPT and Police and Fire Services and had recently been considered by the patient’s participation group for STP and had been largely supported. 

The plan was measured against a matrix of 5 indicators to ensure the efficacy of the Plan and these were:-

• Non-elective Admissions
• Delayed Transfer of Care in the acute and non-acute sites
• |Admissions to residential care
• Number of Patients at home 91 days after a hospital episode.

2 of the 5 matrix indicators had been achieved in 2016-17.  The non-elective admissions had been missed by 203 admissions previously 1000s achievement.  Delayed Transfer of Care had reduced significantly at the acute site and there were now few local authority attributed delays arising from previous initiatives taken under the better care together fund.  Work was progressing with health trusts to minimise delays in relation to mental health and learning disability facilities going forward.  The LLR A&E Delivery Board had addressed this issue and approved a plan to achieve the target by March 2018. 

The BCF Implementation Manager, NHS England (Midland and East) commented that she was a member of the Assurance Panel and felt the plan was well written and one of the better ones that had been received.  It was pleasing to see an increased focus on delayed care community settings and learning disabilities.  The links to housing needed strengthening as this was significant to peoples’ health and wellbeing.

The Healthwatch Chair expressed concerns at the other challenges in Chapter 2 of the draft and following the risk assessment received recently did not fit completely with the positive narrative and asked for assurances on these aspects.

In response it was noted that there had been a huge reduction in delayed transfer of care and non- elective surgery admissions which had reduced the number of 14-15 delayed transfers per week to the current level of 8-10.  This represented a 2.62% reduction in the number of patients in beds than the previous year which was considered to be a significant achievement.   Year on year reductions where now being observed which was seen as a significant improvement against the previous backdrop of 5-6% growth per year.

A Member commented that the supporting appendices sent out after the agenda had been published, particularly in relation to the high impact changes to support local health and care systems to reduce transfers of care in LLR, had many action listed in them but it was hard to see what impact these actions had achieved.  For example, the care homes with most ambulances attendances and the Braunstone Blues initiative supporting care homes who had highest use of ambulances, by providing policy change and education (EMAS). 

It was also noted that the Braunstone Blues initiative had had a dramatic impact in reducing the number of ambulance activations to the 2 care homes and the conveyance rate had increased

It was also noted that the impact of actions could be put into a summary when final plan was submitted with a comment on the impact they made to make it easier to digest the document.

It was considered that any additional information that makes the document easier to read from a lay perspective to enable readers to assess the impact of actions and initiatives was to be welcomed.  

RESOLVED:

1)         That the draft narrative of the Leicester City Better Care Fund plan 2017-19 be approved and that the Chair of the Health and Wellbeing Board be given delegated authority to approve the final narrative plan and planning template prior to its formal submission.  

2)         That the Board receive regular monitoring and progress reports so that any system critical areas of challenge can be addressed and resolved.