Agenda item

The Strategic Director Social Care and Education submits a report which notes the outtuen of the Better Care Fund (BCF) activity and performance for 2018/19 and summarises the intentions for the 2019/20 plan. The BCF plan was a two year plan from 2017-19 and a new plan for 2019/20 is due for submission by 27 September 2019 to be approved for submission by the Health and Wellbing Board.

The Adult Social Care Scrutiny Commission are recommended to note the contents of the report and make any comments to the Strategic Director Social Care and Education.

Members of the Health and Wellbeing Scrutiny Commission have received an invitation to attend and participate in the joint consideration of the agenda item.

Members from Health and Wellbeing Scrutiny Commission were asked to join Members at the table for consideration of the agenda item. Councillor Fonseca and Jeremy Bennett, Strategy Implementation Manager for Leicester City CCG were present.

The Strategic Director Social Care and Education submitted a report which noted the outturn of the Better Care Fund (BCF) activity and performance for 2018/19 and summarised the intentions for the 2019/20 plan. It was noted the BCF plan was a two-year plan from 2017-19 and a new plan for 2019/20 was due for submission by 27 September 2019 to be approved for submission by the Health and Wellbeing Board. The Adult Social Care Scrutiny Commission was recommended to note the contents of the report and provide any comments and feedback to the Strategic Director Social Care and Education.

Ruth Lake, Director of Adult Social Care and Safeguarding presented the report, and gave the following additional information:

·         Significant funding was received to protect adult social care, and the report set out the delivery of BCF with specific reference to national metrics.

·         It was a good news story in times of rising demand and a challenged health and care system.

·         There had been an increase in emergency admissions, but growth figures were lower than the national average.

·         Two-years figures for delayed transfers of care (DTOC) showed improvements for 2017/18. Although strong performance had been sustained for 2018/19, ASC struggled to meet the national targets (as it had done so well in Q3 of 2017/18 and targets were set using 2017/18 performance).

·         The graphs showed trajectory around DTOC and Leicester was recognised as a regularly top performing authority.

·         People were supported to enable them to live in their homes as long as possible, reducing the number of people having to move out of their community.

·         The national target of 92% for people aged 65+ discharged from hospital and at home 91 days later was exceeded at 95.3%.

·         The iBCF was spent on service in accordance to the following categories: support to adult social care, the NHS, the care market.

·         The 2019/20 BCF plan will be submitted 27 September 2019. No significant changes were proposed, and ASC had been able to invest in some new preventative services, for example, eye clinic liaison support.

·         The biggest challenge facing the service was the ability to plan when it was not known if funding would continue.

In response to Members’ questions, the following was noted:

·         Whilst My Choice was predominantly online, people had access to professionals and voluntary sector organisations in a format easy to use on mobiles to enable individuals to help people access the service. People could still telephone the council, and a contact response team was maintained to provide information and advice, take referrals, and uphold safeguarding.

·         The increase in numbers under the 91-day reablement was relatively small, but because it was an increase it was investigated to see if more could have been done. It was found that sometimes when people on the reablement programme came out of hospital, something unpredictable could occur, and there were no concerns that things could have been done differently.

·         Members made reference to revenue outturn underspends at Appendix 2 in the report as a cause for concern that schemes were not being delivered, for example, frailty training for GPs. it was noted that funding in the BCF looked at one-off schemes and had a pooled budget with the agreement of partners. Underspends carried forward a small NHS reserve pot as allocated to the authority and would be considered as carry forward for the next year.

·         In terms of support to ASC commissioned services need to be maintained. Three years ago it became evident that ASC was in financial trouble, and rather than give local government funding directly, the government gave money to iBCF, and conversations were had with CCG health colleagues on how to spend the funding. It was not yet known what future funding would be received from government.

Micheal Smith, Healthwatch Leicester, queried the implications for the BCF following the development of Primary Care Networks (PCNs). Steven Forbes, Strategic Director noted that the BCF was essentially a mainstream funding stream for ASC but routed through the NHS by central government. There had been indications that BCF money could be routed through PCNs, which would be challenging if ASC and the CCG were required to negotiate with 10 PCNs about city services. Ruth confirmed that she had discussed the BCF recently with the BCF regional manager and there was no indication that this was likely.

Ruth noted that the PCNs were at different stages of development and ASC / CCG were working with the PCNs to help them to understand the BCF offer and its benefits. Jeremy Bennett agreed with this noting that the Accountable Clinical Directors for the PCNs were unlikely to not want to benefit from the very good range of services offered through the BCF, as their impact was clear and well regarded.

The Chair thanked officers, Members of both Commissions and Jeremy Bennett for their contributions, and asked Members of the Adult Social Care Scrutiny Commission to agree the recommendation in the report.

AGREED:

1.    That the contents of the report be noted.