Agenda item

A report by Executive Director Children, Adults, Families, Health and Education.

The report informs the Committee of how the improved Better Care Fund has been spent in the 2017/18 financial year.

The Health and Adult Social Care Select Committee is asked to:

i.            Review how the iBCF has been spent in the financial year 2017/18 and whether the outcomes achieved meet the intended use of the funding as set out in the grant conditions;

ii.           Agree that the Committee should reviewiBCF investment for the financial year 2018/19 in terms of outcomes achieved, scheme suitability and priority at a future meeting.

6.1     The Committee considered a report by the Executive Director, Children, Adults, Families, Health and Education (copy appended to the signed minutes) which was introduced by Martin Parker, Head of Integrated Adult Care Commissioning, who told the Committee the iBCF had three grant conditions: -

1.   Pool the grant funding into the local Better Care Fund (BCF) so it       comes within the Section 75 agreement that governs arrangements         of BCF spend

2.   Work with relevant clinical commissioning groups and providers to    meet the Integration and Better Care Fund National Condition 4         (Managing Transfers of Care), and

3.   Provide quarterly reports

•       There was a possibility that iBCF funding would be withdrawn, but this did not happen due to the good performance of the Council regarding Delayed Transfers of Care (DTOCs)

•       The iBCF has been used to: -

Ø  Support the Council to fulfil its Care Act duties to meet eligible assessed needs

Ø  Mitigate the risk of overspending in the Adult Social Care budget due to increased demand and complexity

Ø  Reduce the number of days people remain in hospital

Ø  Ensure that people have the appropriate care and support to meet their longer-term needs and remain independent in their own home

Ø  Support providers in the care market so as to prevent disruption to people receiving care

•       There is an uncommitted budget of £1.3m that the Council could have used to meet the adult social care overspend, however it has been agreed that the funding be taken forward to fund one-off adult social care costs that deliver system-wide benefits

6.2   Summary of responses to committee members’ questions and comments: -

•       A small amount of iBCF money had been used to create a small team responsible for working with providers to develop recruitment, retention and capacity plans and to identify and support providers with workforce training.

•       DTOC figures come out six weeks after the end of each month, the latest were for April which showed a slight increase – the Council was working with the clinical commissioning groups on year round resilience planning

•       Shortfalls in 2017/18 spending were as follows: -

Ø  Workforce development – £16k was spent on four recruitment campaigns, the balance was designated to create a small team that was not recruited until after the 17/18 financial year end.

Ø  Investment in occupational therapists – this was due to problems in recruitment (a campaign to recruit more occupational therapist had recently been launched)

Ø  Transfers from community health services – this was a two year plan for which costs were expected to be higher

Ø  Implementation of the High Impact Change Model – work is still ongoing with the three accident & emergency boards across the county to establish this

Ø  Lifelong conditions – work to review packages of care had started but would need  to continue into 2018/19 as will work to source appropriate services and managing underspends in the joint health and social care budget

•     The timing of the iBCF announcement and the necessary consultation with partners had taken time which had caused some delays in delivering elements if  the Council’s spending plan – full expenditure was expected during 2018/19

•     iBCF grant conditions clearly state that iBCF money can only be used for social care spend and therefore can only be used on DTOCs that were attributed to delays due to social care

•     The Council was aligning its services now with health and aimed to integrate them from 2020 in accordance with NHSE and Government plans

•     Pooled budgets worked well in mental health and learning disability services where there was joint commissioning and provision

•     The Council is working with a contracted residential service to increase dementia beds in the community

•     Money had been set aside to establish a Technology Enabled Lives Service investment fund that would be used to support the sourcing of a Technology Enabled Lives service by the end of the 18/19 year

•     The Council couldn’t use iBCF money to help clear NHS deficits as that would not meet the iBCF grant conditions

6.3     Resolved – that the Committee: -

     i.        Agrees that the improved Better Care Fund money spent in 2017/18 achieved the outcomes and intended use of the funding as set out in the grant conditions

    ii.        Agrees that it should review improved Better Care Fund investment for the financial year 2018/19 in terms of outcomes achieved, scheme suitability and priority at a future meeting