Agenda item

Better Care Fund Progress

To receive an update and feedback on Better Care Fund spending proposals for 2019/20 onwards.


Paul Robinson, NHS Midlands and Lancashire Commissioning Support updated the Board on the Better Care Fund progress.


Better Care Fund Metrics


1.  Reablement - performance continued to be better than target with 88.2% of people being at home 91 days after discharge from hospital and an increase in the number of those using the service.

2.  Permanent admissions to residential and Nursing Care - for the full year up to the end of Q2 performance had improved slightly and remained better than plan.  However, Lancashire still had a high rate of admission to permanent residential and nursing home care for older people.

3.  Non-elective admissions - from a position of being above plan in Q3 2017/2018 actual had decreased gently to being better (below) plan in Q2 2018/2019.

4.  Delayed Transfers of Care - performance had been better (below) target. However, this disguised that Delayed Transfers of Care increased in September to above plan and were continuing to do so.


The Future of the Better Care Fund/Integration


The NHS Long Term plans confirmed the continuation of the Better Care Fund into 2019/2020 but with a national review of it underway. The review outcome and planning framework were promised soon.


Alongside this review and the anticipated new framework, planning of a Lancashire wide review was underway that would reset the Better Care Fund in a context of integrated care system proposals for the integration of health and social care.


In developing further the Better Care Fund there were plans to hold a workshop in March around integration which would explore lots of factors in the care system and link in with whatever was coming out of the NHS Long Term Plan and not just focus on what was in-scope from the Better Care Fund.  The Board would like to see the workshop on integration to be more transformational than transactional when we review the future arrangements for the Better Care Fund.  Paul Robinson would inform the Board of the date when this had been arranged.


Active Ageing Pilot


The Better Care Fund Steering Group had considered the proposal and recommended that this was not supported at this time.  Should the funding position become clearer with increased flexibility the proposal could be reconsidered at the request of the Health and Wellbeing Board.


Chair of Better Care Fund Steering Group


Since Mark Youlton's retirement from the NHS and stepping down from the Health and Wellbeing Board and role of Chair of the Better Care Fund Steering Group, Tony Pounder as the Deputy Chair had taken on the role of Interim Chair of the Better Care Fund Steering Group, probably until the end of March 2019. 


The Better Care Fund Steering Group would agree a nomination to the role of permanent Chair in due course and seek the approval of the Chair of the Health and Wellbeing Board to confirm the nomination, with the intention of picking up the role from April 2019.  Dr Julie Higgins agreed to continue Mark's role as Chair of the Better Care Fund Steering Group.  There was also a suggestion at changing the name to possibly Integrating Working Group which might influence who was sat around the table.  The group need to look at doing something completely different now with the five year plan, aligning all the bids for the system, integrate and embed them.


Resolved:  That the Health and Wellbeing Board:


i)  Noted the performance against the Better Care Fund metrics.

ii)  Noted the national indications of continuation of the Better Care Fund subject to a review and new planning framework.

iii)  Noted the local plans to review the Lancashire Better Care Fund in a broader context of integration

iv)  Required a detailed report on Better Care Fund and integration once both reviews were complete and full planning frameworks and guidance were available.

v)  Agreed to the recommendation of the Better Care Fund Steering Group not to support a pilot of the Active Ageing Alliance pilot.

vi)  Agreed to the Better Care Fund Steering Group identifying a nominee for the position of Chair of that group and for the confirmation of that nomination to be ratified by the Chair of the Health and Wellbeing Board.

vii)  Noted that Louise Taylor, Executive Director for Adult Services and Health and Wellbeing would report on the propositions from the joint session held with Lancashire, Blackburn, Blackpool, Cumbria and care providers at a future meeting.


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