Agenda item

To receive an update on the Better Care Fund Quarter 4 performance including the Delayed Transfers of Care Performance through Newton Europe and BCF planning.

The year 2017/18 saw considerable activity and change across the Lancashire Better Care Fund (BCF).  The performance against metrics was good for both reablement and reducing the numbers of permanent admissions to residential and nursing homes.  It was also so for the number of non-elective admissions that were slightly below the target.

The main area of focus for the year was the level of Delayed Transfers of Care (DToC) across hospitals in Lancashire and the split of responsibility for these across health and social care.  There was an overall reduction during the year that saw a convergence towards the revised and highly challenging targets.  The greater reduction was seen in social care attributable delays. 

There was a high level of cooperation and challenge across the whole health and social care system that has resulted in improved Delayed Transfers of Care performance and a continuing improvement in collaborative working that includes the voluntary sector and district councils.

The level of funding via the Better Care Fund increased overall and was then supplemented by the Improved Better Care Fund (iBCF).  This required and ultimately enabled better joint working and decision making across health and social care and targeting of new and enhanced services at shared priorities.

Such was the challenge around Delayed Transfers of Care that national resources were allocated to provide currently ongoing Delayed Transfers of Care diagnostic work that has presented its findings and is now shaping up how the improvement themes will be applied. 

As there is a two year Better Care Fund and an Improved Better Fund plan in place there is no need for further detailed planning at present.  The NHS plan and social care green paper due in Autumn will provide detail of the nature and purpose of the Better Care Fund beyond 2019/20 although it has been indicated that there will be an increased emphasis on integration and the Better Care Fund will be at the centre of this.  A report will be provided to the board when the information becomes available.

The Disabled Facilities Grant funding at Wyre District Council had been used in innovative ways and this had been shared with other Districts.

It was reported that, notwithstanding progress made, parts of the Better Care Fund resources are non-recurrent and ending in two years' time.  It was noted that there were schemes funded by the local authority and the NHS that were not included in the Better Care Fund but were intended to achieve same outcomes as the Better Care Fund.  The Board agreed to scope and review the overall health and care budget that fund these schemes to inform planning beyond the Better Care Fund period. 

Resolved:  That the Health and Wellbeing Board:

i)  Noted the Better Care Fund annual summary provided at Appendix 'A'.

ii)  Requested a further report on the outcomes of the Delayed Transfers of Care diagnostic work once this is completed.

iii)  Requested a report on future planning requirements for the Better Care Fund once this was known.

iv)  Organise a workshop to scope and review the total system budget and develop an integration plan beyond 2019/20.