Agenda item

Briefing Note of the Director of Adult Services

The Board considered a briefing note of the Executive Director of People which provided an update on the Better Care Fund (BCF) Plan for 2017-19, a copy of the plan was attached as an appendix to the note. The briefing note had previously been considered by the Coventry Health and Wellbeing Board at their meeting on 16^th October, 2017 and the Board had given their approval to the Plan. Councillor Abbott, Cabinet Member for Adult Services attended the meeting for the consideration of this issue.

The briefing note indicated that the integration of health and care had been a long standing national policy ambition based on the premise that more joined up services would help improve the health and care of local populations and make more efficient use of available resources. Prior to, and subsequently alongside the Better Health, Better Care, Better Value programme, the BCF was implemented in 2015 as part of the government drive to integrate health and care. In response a BCF Plan was developed locally. A new plan was now required to cover the period 1^st April, 2017 to 31^st March, 2019 including how the Coventry element of additional funding in the spring budget for Adult Social Care was to be used.

The Board noted that the planning schedule meant that the planning tools were available in July, 2017 with the plan being submitted by 11^th September, 2017. Meeting timescales meant the plan was only endorsed by the Health and Wellbeing Board in October.

The total value of the 2017-19 pooled budget from ring-fenced City Council and Coventry and Rugby CCG funds was £179.5m (£63.897m of local authority resources and £115.605m of CCG resources).

The Board were informed that a detailed policy framework for the implementation of the BCF was published in April, with further detailed guidance on delayed transfers of care being issued to local areas in July. There was an expectation that delayed transfers of care should equate to no more than 3.5% of all hospital beds by November, 2017. It was emphasised that this was extremely challenging to Coventry and a trajectory had been included within the BCF Plan to meet this expectation.

Detailed financial and operational plans had been developed to reflect the current CCG and social care priorities within the city. The following three purposes had been assigned to the additional BCF grant announced in the spring budget and set out in the plan:

To meet Adult Social Care

To provide support to the NHS (especially through the application of 8 high impact changes)

To sustain the social care provider market.

The plan recognised that as well as achieving effective discharge, preventing admission to hospital was just as crucial to the effectiveness of the health and care system. Consequently activity under the BCF would also focus on a range of projects that sought to improve support to people away from the hospital setting.

The briefing note highlighted the mandatory content and the national conditions contained in the plan and provided an update on governance. Following the submission of the plan by the NHS deadline of 11^th September, and a revision to the delayed transfer of care targets meaning a re-submission on 20^th September, a single stage regional assurance process was now underway. This would be followed by moderation and the cross regional calibration. Formal letters indicating the results of the assurance process would then be issued by NHSE. The Board were informed that there were three assurance categories: approved, approved with conditions and not approved. It was anticipated that the Plan would be approved with conditions. The consequences of the plan not being approved were highlighted.

The Board questioned the officers on a number of issues and responses were provided, matters raised included:

·  The implications of the winter season affecting the trajectory targets for delayed transfers of care

·  If consideration would be given to looking at other commissioning models e.g. Northumberland

·  The impact of increasing numbers of people with dementia

·  The rehabilitation support available for patients leaving hospital in short term accommodation and in their own homes

·  Support for the patient support networks in the city

·  Clarification about the figures for delayed transfers of care –what was considered to be high and the current position in the city

·  Further information about the partnership working around delayed transfers of care

·  Further details about spending commitments and how spending was monitored

·  An assurance that the figures for delayed transfers of care were on track to meet the November targets.       

RESOLVED that:

(1) The content of the Better Care Plan be supported.

(2) A report on health and social care integration in Coventry be submitted to a future meeting of the Board.