Agenda item

The Better Care Fund (previously referred to as the “Integration Transformation Fund”) was announced in the June 2013 spending round covering 2015/16.  This national £3.8 billion fund, established by the Department of Health, is to be held by local authorities and will include funding previously transferred by local NHS commissioners to the Council under Section 256 Agreements.

This report sets out expectations about the use of the Better Care Fund (the Fund); the development of joint plans for the use of this funding; and associated sign-off and governance requirements in light of the publication of detailed guidance as an annex to the NHS England Planning Guidance on 20 December 2013 and joint statement by the Department of Health and Department for Communities and Local Government.

The Fund “…provides an opportunity to transform local services so that people are provided with better integrated care and support. It encompasses a substantial level of funding to help local areas manage pressures and improve long term sustainability. The Fund will be an important enabler to take the integration agenda forward at scale and pace, acting as a significant catalyst for change.”

The Board is asked to:

1)  Note the national planning guidance set out in this report, including the key requirement for the Board to formally sign off the local Better Care Fund plan in March 2014 for submission by 4th April 2014.

2)  Consider the requirement to select a local metric as summarised in paragraphs 5.28 to 5.30 in this report and potential use of flexibility to agree a local alternative, which could be Hospital admissions as a result of self-harm.

3)  Consider whether it is appropriate to host or undertake joint stakeholder engagement on the local Better Care Fund plan alongside the CCG’s engagement on its wider strategic and operational plans in line with the requirements of Everyone Counts: Planning for Patients 2014/15 to 2018/19.

4)  Agree to receive a further report, including the draft local Better Care Fund Plan, at its next meeting on 26th March 2014, with the aim of signing off the plan for submission by 4th April 2014.

The Chair invited Jane Shayler (Deputy Director for Adult Care, Health and Housing Strategy and Commissioning) to introduce the report.

The Chair commented that the Better Care Fund (BCF) was a great idea as it would bring all health and social care funds together, in one pot, and deliver better outcomes.  The delivery timescale were quite tight, in particular for the Clinical Commissioning Group (CCG) and the Council.

The Chair also supported local metrics as it met the Health and Wellbeing Strategy requirements.

Tracey Cox commented that some proprietary work had been done around baseline understanding against some of the outcomes and metrics.  One particular work had been undertaken around dementia diagnosis, something that the CCG was required to set in its own plan, which could be presented to the Panel in near future.

Jo Farrar acknowledged that this was a significant change and a lot of hard work had been put in this area.  The Council recognised that this would be new money, and the Council would be keen to work with health bodies on this issue, in the smoothest possible way.

John Holden expressed slight concern that the proposal of the local BCF plan would have to be submitted by 4^th April 2014, and considering that the NHS and the CCG would have to produce their two year and five year plans, there could be too much pressure put on small teams.  John Holden also said that short timescale would leave little time for innovative thinking.

Dr Ian Orpen commented that two year and five year plans were discussed with neighbouring CCGs, and one of the issues discussed at that meeting was the BCF.  From the discussion with other CCGs it was evident that B&NES CCG had had quite cohesive and collaborative partnership work with the Council when compared with other CCGs in the area.

Councillor Dine Romero expressed her concern that the BCF was aimed to adults only and not to children and young people.  Councillor Romero asked if it would be possible to be more explicit by saying that the BCF would be for adults’ health and wellbeing and specify direction where children and young people’s health might be addressed.

The Chair welcomed the comment from Councillor Romero and said that there was no explicit suggestion that the BCF was for adults only.

Jane Shayler added that there was nothing indicated that funding for children’s health and social care was precluded in use of this funding.

Councillor Katie Hall reassured John Holden that the work around the BCF was not sudden.  The Council and the CCG had known for some time about the BCF.

Douglas Blair commented that the NHS England had been encouraging people to think that this was a mechanism for support strategies. 

Paul Scott asked if there would be one metric, one indicator, or a range of metrics.  Paul Scott suggested that domestic violence could be another issue to consider, whether as new metric or to be funded directly from the BCF.

Jane Shayler responded that it would be one local metric, though there would be a series of national metrics.

Ashley Ayre commented that a discussion at the CCG Board meeting generated an idea on the local indicator around children and young people.  Ashley Ayre welcomed a suggestion from Paul Scott about domestic violence metric.  Ashley Ayre highlighted a need for a right vehicle for tough discussions on how resources would be recycled into preventative services.

It was RESOLVED to:

1)  Note the national planning guidance set out in this report, including the key requirement for the Board to formally sign off the local Better Care Fund plan in March 2014 for submission by 4th April 2014.

2)  Select ‘Child and adolescent mental health’ as local metric for the time being, subject to further assessment of local data.

3)  Support intent to host or undertake joint stakeholder engagement on the local Better Care Fund plan alongside the CCG’s engagement on its wider strategic and operational plans in line with the requirements of Everyone Counts: Planning for Patients 2014/15 to 2018/19.

4)  Receive a further report, including the draft local Better Care Fund Plan, at its next meeting on 26th March 2014, with the aim of signing off the plan for submission by 4th April 2014.