Decision details

The recent publication of the Integration and Better Care Fund (BCF) guidance 2017/19 had set out the continuing role for the BCF and confirmed the ongoing conditions and requirements that varied little from those set out at the creation of the current Lancashire BCF plan in September 2017.

The role of the Health and Wellbeing Board was reaffirmed as overseeing strategic direction and delivery of the BCF.

Whilst there was an option to revise three of the four national metrics the recommendation of the BCF steering group was that those remain as originally planned.

The fourth metric, Delayed Transfers of Care (DToC), (see attached PowerPoint and comparator document) was the subject of revised nationally imposed expectations which current performance trajectories showed Lancashire should be able to achieve in 2018/19.  It was important to emphasise that this was only achievable because of the combined efforts across the Lancashire health and social care system that had resulted in significant improvement in performance and a drop of total delayed days from 4643 in June 2017 to 2758 in June 2018.

The guidance indicates a shift of emphasis towards impacting on and monitoring length of stays in hospital.  For now, the BCF was expected to support reducing these through its efforts around DToC and the implementation of the High Impact Change Model although further requirements may be identified in coming months.

There was no requirement to create a revised BCF plan but any revisions had to be reported and must continue to meet the BCF/iBCF conditions.  There had been a number of required changes identified in the Lancashire plan and those were set out in Appendix B.

Discussion ensued around the success of better working together across sectors and reducing delayed transfers of care figures, however the Board were reminded that the iBCF was non-recurrent and to ensure that the working targets were sustained, work that had been carried out by Newton Europe should be used to put schemes in place.  This was something that the Better Care Fund Steering Group needed to take forward.

It was requested that the readmission rate figures were included in the report for future meetings.  Paul Robinson agreed to ensure these were provided.

The Board agreed to include Residential Care on the forward plan as a future item as residential numbers were diminishing.

With regards winter plans, Central Lancashire's would be discussed at the A and E Delivery Board on 21 September 2018 and Lancashire County Council's Winter Plan was due to be presented to Cabinet on 11 October 2018.

Active Ageing Alliance

Adrian Leather, Active Ageing Alliance presented the Board with some background and Crispin Atkinson, Redhill Consultants presented the attached PowerPoint.

The Active Ageing Alliance was formed in 2016 from Voluntary, Community and Faith (VCF) sector organisations in Lancashire.  A model had been developed of co-operative working based on a lead contractor and supply chain arrangement and would provide person centred support.  The vision was a far greater role for the VCF sector in meeting the needs of people over 50 for non-medical support.  It had a more efficient approach to commissioning, procurement and supply of services through a lead contractor and co-ordinated supply chain.

59% of Lancashire are over the age of 50.  Some of the benefits of the model were around person centred support and co-operative working which ensured investment, development and support for community assets.

It was noted that when developing the neighbourhood working models that the Active Ageing Alliance should be considered.

Resolved:  That the Health and Wellbeing Board:

i)  Noted the guidance and its implications for the Lancashire BCF and Health and Wellbeing Board.

ii)  Approved the revisions to the BCF/iBCF plan, for 2018/19, as set out in Appendix B.

iii)  Approved the maintenance of the BCF metrics for Non Elective Admissions, Residential and Nursing Home Admissions and reablement at the original 2017/19 plan levels.

iv)  Noted the expected performance for Delayed Transfers of Care for 2018/19.

v)  Noted the success of joint working across health and social care in significantly improving DToC performance and enabling the expectations to be met.

vi)  Requested that the Better Care Fund Steering Group review the Active Ageing Alliance model, consider its inclusion as part of the wider Better Care Fund spending proposals for 2019/2020 onwards to be agreed at a future Health and Wellbeing Board meeting.

vii)  Requested that the readmission rate figures were included in the report for future meetings. 

viii)Agreed to include Residential Care on the forward plan as a future item.