Agenda item

The Cabinet Member will update the Select Committee on any relevant issues. Select Committee members may ask questions on the update provided.

Councillor Vic Pritchard, Cabinet Member for Adult Social Care & Health addressed the Select Committee. A copy of the update can be found on their Minute Book and as an online appendix to these minutes, a summary of the update is set out below.

Improved Better Care Fund (iBCF) 2017/18-2018/19

The Improved Better Care Fund (iBCF) Policy Framework was published in April 2017. Adult Social Care Grant conditions and detailed implementation guidance from NHS England (NHSE) were due to be published in April 2017.  However, publication has been delayed and whilst the revised date for publication has not been confirmed it is not anticipated that this will be in advance of the general election on 8 June. 

In Bath and North East Somerset 2016/17 saw a continued increase in pressure on the adult social care budget. These have arisen as a direct result of implementation of the National Living Wage and the costs associated with purchased care packages.  In addition, there are pressures arising from support to people with complex and acute needs in their own homes, including those with a learning disability transitioning into adult services and living longer with high levels of care and support needs.  There is also an increasing demand for high dependency residential care and nursing care home placements.

Health and Wellbeing Board Development

Following the introduction of the Health and Social Care Act in 2012, a formal Health and Wellbeing Board (HWB) was established in order to bring together leaders from the local health and care system to improve health and wellbeing.

There is a strong commitment to working in partnership to improve health and wellbeing, good relationships between Board members and a clear understanding of the needs and issues within B&NES.

As part of a series of reflective sessions last year, members began to articulate the direction they wanted to see the Board move in. This includes the Board’s focus on building a truly whole-place approach to health and wellbeing in B&NES - bringing organisations together around the local people and communities we all serve.

The HWB proposed to broaden its membership to include wider representation from key health and social care providers and public services. This would enable the HWB to more directly engage these wider services, identify areas of common focus and demonstrate their stake in the health and wellbeing agenda. The proposed new membership included representation from Police, Fire, Housing, and Education as well as providers from Acute, Community, Primary and Voluntary Sector Care.

The HWB wrote to these proposed new members during the early part of this year to engage them in these proposals and seek their view on whether they would be interested in joining the Board. This included a voluntary sector recruitment process to identify a representative.

These changes have been set out in a revised terms of reference which was presented to Council at the 18th May AGM and formally adopted.

Councillor Geoff Ward asked what work was being done to ensure that Members and officers work together and not in silos to focus on one of the main objectives to allow older people to remain in their own home for as long as is possible.

Councillor Pritchard replied that this issue was to be covered by the Health & Wellbeing Board. He added that a housing representative was now on the Board. He said that alongside the need to comply with the Sustainability and Transformation Plan he wanted the Council to build a foundation of independence.

Councillor Tim Ball asked for the guidance relating to the Improved Better Care Fund to be shared as soon as possible.

Councillor Lin Patterson said that she believed that the proposal described in Home First Proposal 4 to commission 5 beds for a 12 month period for temporary assessments within nursing homes for a maximum of 6 weeks whilst assessments were made was not enough.

Councillor Pritchard replied that initially there had been a plan for there to be 8 beds but that they were operating under financial constraints.

The Director for Integrated Health & Care Commissioning added that the current proposal would enable the model to be tested and evaluated.

Councillor Eleanor Jackson asked for a fuller discussion on the proposals at the next meeting of the Select Committee which would be after the General Election.

The Director for Integrated Health & Care Commissioning commented that the Joint Commissioning Committee had received a report on the proposals and that this could be circulated to the Select Committee and then a focussed briefing could be given at the next meeting.

Councillor Eleanor Jackson replied that this would be very helpful. She said that she was aware of applications coming into the Council for Dementia Care Homes and asked if there was an understanding of what resources were needed locally.

The Director for Integrated Health & Care Commissioning replied that a report on this issue could be scheduled for a future meeting.

Councillor Paul May asked if our CCG were considering similar plans to those proposed by Bristol, North Somerset & South Gloucestershire to transfer funds between Acute Services and Care Services.

The Director for Integrated Health & Care Commissioning replied that the context within those Local Authorities mentioned is different to ours and that they have very significant financial savings to make. She added that there are links in some work areas, particularly Mental Health, but that generally the STP differences are recognised.

Councillor Paul May asked if the matter of Community Pharmacies within B&NES had yet been discussed by the Health & Wellbeing Board.

Councillor Pritchard replied that it would be an agenda item for a future meeting of the Board.

The Chair thanked Councillor Pritchard for his update on behalf of the Select Committee.