Agenda item

Report of Pete Fahy, Director of Adult Services

The Board considered a report of Pete Fahy, Director of Adult Services, which provided an update on the approval process for the Coventry Better Care Fund for 2020/21.

The report indicated that the Government’s mandate to the NHS, published in March 2020, included manifesto commitments to further improve the experience of NHS patients, working with local government to support integration and the sustainability of social care through the Better Care Fund (BCF). The Covid-19 pandemic led to Health and Well Being Boards (HWBs) being advised by Government that BCF policy and planning requirements would not be published during the initial response to the pandemic and that the continuity of provision, social care capacity and system resilience based on local agreement should be maintained and prioritised.

Further to this and given the ongoing pressures on health and care systems in responding to the pandemic, in December 2020, the Department of Health and NHS Improvement agreed that formal BCF plans would not have to be submitted for approval in 2020/21.  It was however a requirement that HWB areas must ensure that use of the mandatory funding contributions had been agreed in writing between the Clinical Commissioning Group and the local authority, and that the national conditions would be met.

The Board were informed that, in order to fulfil the requirements each HWBB area would be required to provide an end of year reconciliation to the Department of Health and NHS England, confirming that the national conditions had been met; total spend from the mandatory funding sources; and a breakdown of agreed spending on social care from the CCG minimum contribution. To support this process a template was issued for local areas to complete (but not submit) which summarised the financial position and checked that requirements had been met. It also provided the basis for the end of year reconciliation.

The Board noted that the template had been completed and agreed by the Local Authority and Coventry and Rugby Clinical Commissioning Group as required. A section 75 variation had been finalised as written signed agreement to the programme. The previously signed Section 75 remained in force until this subsequent variation was completed. The variation enabled a change to the financial values included in the programme for the 20/21 financial year.

The report detailed the national conditions for the BCF in 2020/21. The guidance stated that CCGs and local authorities should also ensure that local providers of NHS and social care services had been involved in planning the use of BCF funding for 2020 to 2021. In particular, activity to support discharge funded by the BCF should be agreed as part of the whole system approach to implementing the Hospital Discharge Service Policy and should support an agreed approach for managing demand and capacity in health and social care – The 2020/21 plan was a continuation of previous plans that had previously involved other providers in the process. The onset of the pandemic had continued to drive joint working across hospital discharge arrangements and the pre-existing investment in discharge to assess services from the Better Care Fund had enabled Coventry to respond to the additional pressure over the past year.

The report detailed the allocations for the 2021 Better Care Fund which comprised a total pooled budget of £116.496m.

Alongside the main BCF programme, as part of the Covid19 response, Government provided additional funding to support Hospital Discharge which formed the basis of a separate section 75 variation which had been agreed between the parties

The process required for sign off for 2020/21 BCF was issued on 3 December 2020.  Unfortunately, there was insufficient time to complete the requirements and in advance of the last Board meeting on 25 January 2021.  Therefore, the report was being considered post submission at the meeting closest to the 31 March 2021.

The Board were informed that the requirements for BCF planning for 21/22 had not yet been published and no specific date for publication had been provided. An update would be provided in due course.

RESOLVED that the report be accepted as completion of the final stage of the 2020/21 Better Care Fund process, albeit retrospectively.