Agenda item

The Director of Adult Social Care and Safeguarding submits a report that sets out the new requirements of the Better Care Fund (BCF) for 2017-2019.

The Commission is asked the note the update and comment as it sees fit.

The Director of Adult Social Care and Safeguarding submitted a report that set out the new requirements of the Better Care Fund (BCF) for 2017-19. The Director and Rachna Vyas, Deputy Director of Strategy, Leicester City Clinical Commissioning Group (CCG) introduced the two year plan.  The Commission heard that the authority was building on the scheme’s previous successes and the allocation of funding depended on a scheme’s performance.

Members considered the report and during the ensuing discussion, the following comments and queries were raised:

·      It was noted that the statistics for Leicester indicated that the City was 10% over plan for Emergency Department (ED) attendances. Members heard that this was old data within the 16/17 update appendix, and current data indicated that attendance had stabilised.  There had been a small rise in the number of children being admitted into the ED; this was in part due to the new Children’s ED and an increase had been expected and planned for.

·      The issue relating to double counting of patients (patients who were seen in the Urgent Care Centre and then again in the ED) had arisen due to disparate IT systems, but this was being rectified.

·      A Member referred to the Sustainability and Transformation Plan (STP) and expressed some concern as to its effect on the BCF and how it would be managed. The Strategic Director for Adult Social Care explained that the BCF had running for four years; in Leicester, the BCF schemes were working well for individuals and were effective in keeping people out of hospital. The Council would protect and continue to put resources into the fund. However, the BCF was part of the wider STP; Leicester had some influence in the scheme and needed to promote the scheme to ensure future funding. A Member suggested that it might be useful for the Adult Social Care Scrutiny Commission to write to the STP Board to seek assurance about the future of the BCF.

·      Micheal Smith commented that Healthwatch had witnessed effective interaction in the Admissions and the Emergency Department and its preventative work to reduce future admissions. The Deputy Director of Strategy, Leicester City CCG added that some colleagues from the County had noticed how effective the City Council strategies were and had requested further details.

·      A Member referred to the reasons for LPT Mental Health delays which pointed largely to patients awaiting completion of health assessments. The appended 16/17 update report stated that no improvement had yet been seen, but the Deputy Director of Strategy commented that since then, the situation had improved.

·      The Strategic Director explained that in relation to delayed discharges, there was an issue around the availability of appropriate housing. Suitable accommodation could not always be found for some patients whose needs were particularly challenging. Concerns were expressed that it would not be helpful for patients to be kept in a hospital setting because appropriate accommodation could not be found. It was questioned what was happening nationally and it was suggested for the Scrutiny Policy Officer to carry out some research into the lack of appropriate housing across the country.  This could perhaps be brought to a joint Scrutiny Commission meeting with Health and Adult Social Care.  The Strategic Director added that finding suitable accommodation was part of the issue; there was also a need to find the right service to support the person’s needs.

·      A concern was expressed that there were issues relating to the deprivation of liberty, where people were kept in hospital because of the lack of suitable accommodation. The Strategy Director commented that the issue was about managing the risk appropriately when someone was discharged.

·      The Chair expressed a view that there were many benefits to be gained by gardening, both physical and social, and more should be done to encourage this activity.

·      Concerns were expressed that some organisations, such as Network for Change, who provided support for people with complex needs, were closing down due a lack of funding.

The Chair drew the discussion to a close and thanked officers for the information provided.

AGREED:

1)    that a letter be sent to the Sustainability Transformation Plan Board asking them to note the very good work taking place by Leicester City Council on the Better Care Fund , and to seek assurances that the commitment would continue;

2)    for the Scrutiny Policy Officer to carry out some research relating to the availability of suitable accommodation across the country, for people with complex needs and awaiting discharge from hospital; and

3)    for a further update be brought back to the Commission in six months time.