Agenda item

To receive an update report on the Better Care Fund (BCF) Quarter 3 performance including the DToC Performance update, DToC Check and Challenge progress, Better Care Support Team DToC diagnostic support through Newton Europe and BCF planning for 2018/19.

Paul Robinson, NHS Midlands and Lancashire Commissioning Support Unit was welcomed to the meeting to present the Quarter 3 performance including the Delayed Transfers of Care (DToC) performance update, DToC Check and Challenge progress, Better Care Support Team DToC diagnostic support through Newton Europe and BCF planning for 2018/19.

i)  BCF Quarter 3 2017/18 report

Non-elective admissions exceed target by 4.3%.  The Q3 performance position for Permanent admissions to residential and nursing care homes is 31 admissions over target (2%).  The effectiveness of reablement continues to be demonstrated with increasing numbers of users 1304, with 1140 of those still at home after 91 days.

ii)  Delayed Transfers of Care (DToC) performance update

There were 7.4% less recorded delayed days than in the same period last year.  However, this is 50% above the target set centrally.  Some improvement against that target can be seen between November and December.  During the quarter the balance between NHS and Social Care attributable delays had shifted slightly to Social Care attributable delays being the greater.  The latest available data, January 2018, shows a continuation of the overall improvement.

From August 2017 to January 2018 there was over 1000 days reduction in delayed days, so something is having an effect.  With regards the 3,479 total of delayed days, Paul was asked how many people this affected. 

Resolved:  Paul Robinson agreed to find out how many people the 3,479 delayed days affected and would report back to the Board.

iii)  DToC support

An offer from the national Better Care Support Team of support had been accepted by the BCF Steering Group.  This was in the form of DToC diagnostic support to be provided by Newton Europe that would add to that commissioned by Lancashire County Council and connect with that already undertaken in Pennine Lancashire and Fylde Coast.  Central Lancashire have been selected to support this and work will begin in May 2018.  There will be regular meetings with the Chief Executive which will be reported back to the BCF Steering Group and needs to be part of the update received from Paul Robinson at the Health and Wellbeing Board.

Resolved:  The Board agreed that Louise Taylor, Executive Director of Adult Services and Health and Wellbeing would be the key lead with whom Newton Europe would work with and who will provide regular updates on this to the Board.

iv)  DToC Check and Challenge…next steps

The System Wide and High Impact Change Model specific challenges, ideas and actions that came from the DToC Check and Challenge session are forming the basis of an action plan that will connect the delivery through BCF, A&E Delivery Boards and the Urgent and Emergency Care Network.

The Action Plan from the Check and Challenge event was circulated and the Board were asked to look at this and take forward the areas relevant to their services.

Resolved:  The Board to consider the action plan and send their views/suggestions/thoughts to Paul Robinson.

Sakthi reported that a similar event to the Check and Challenge would take place on neighbourhoods and requested that whilst people were working through the action plan, to share also what was happening in the neighbourhoods during another Check and Challenge event.

It was suggested that money was put aside to fund somebody to provide this framework and that the Better Care Fund Steering Group could agree to release some money.  Eleanor Bentley should attend the Better Care Fund Steering Group and report back on this through Sakthi Karunanithi back to the Board.

v)  BCF and iBCF Planning 2018/19 and beyond

In the immediate future, planning would mainly focus on shaping the use of iBCF with the BCF plan remaining closely to its present form.  In the longer term BCF remained central to policy on driving integration and shaping delivery of NHS and social care services.  The planning process especially beyond 2018/19 requires the direction of the Health and Wellbeing Board.  It would mainly stay the same with some minor changes and would come back as a full plan to the Board.

The Better Care Fund Steering Group had considered the approach to be taken into 2018/19 and beyond and recommended:

·  That the focus for immediate planning would be on shaping iBCF schemes for 2018/19 based on the learning of this year, including that through the Check and Challenge session, and making more effective use of resources in a more integrated manner.

·  For most part the BCF plan would remain the same with its schemes to continue.  Some reshaping may be necessary to reflect changing circumstances and opportunities.  This would be based closely on ongoing review of effectiveness of these schemes.

·  The year 2018/19 would be used to shape a more radical use of the whole of BCF into 2019/20.

Specific conversations setting out wider intentions and the Board's response to the development framework to promote integration.

Look at pooling the Special Educational Needs and Disabilities budget and have an accountable officer.  The mechanism is already set up and have a Section 75 to use as a tool and set up a pooled budget.

Resolved:  That the Health and Wellbeing Board:

i)  Noted the performance against the BCF metrics as referenced in points 1 and 2 in the Executive Summary of the report.

ii)  Noted the DToC support offer.

iii)  Approved the approach to coordinate the DToC support with all other DToC work and confirmed the planned outputs and outcomes as set out to the Board in the presentation.

iv)  Reviewed and confirmed the actions set out on the Check and Challenge action plan as presented to the Board.

v)  Agreed the approach to be taken to BCF and iBCF planning and provide challenge and direction, knowledge and leadership to this.

vi)  Considered a specific BCF planning session for the Board.