Decision details

Louise Taylor, Executive Director of Adult Services and Health and Wellbeing provided the Board with an update on the progress of work following the review of Intermediate Care in 2019.

The Better Care Fund (BCF) required the NHS and local government to create a single pooled budget and plan to incentivise closer working around people, placing their wellbeing as the focus of health and social care services, with a strong emphasis on community based services.

To date, the Better Care fund in Lancashire had been used to commission services at the interface between health and social care, including a significant amount of funding linked to short term 'intermediate care' provision.

Following the Intermediate Care review, it was clear that there were further opportunities to:

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·  Improve quality and level of provision for individuals and their carers/families closer to home;

·  Manage demand in both health and social care, and;

·  Maximise the impact of funding across health and social care.

The Intermediate Care Programme was the first test of working in an integrated manner across health and social care, implementing a single set of recommendations across both sectors with accountability, financial reform and risk management being managed through the Advancing Integration Board (formerly Better Care Fund Steering Group).

Members of the Board were asked to consider that as part of the system, how receptive were they being to taking risk. The biggest challenge was resourcing and encouraging people to work differently.

Gary Raphael and Louise Taylor agreed to speak further on progressing joint working outside the meeting and feedback to the Senior Leadership Executive and at the next Health and Wellbeing Board.

The Programme Initiation Document had been drafted, which articulated the transformation plan, resource requirements and benefits for the system. The next steps within this programme were to:

·  Create a detailed Intermediate Care Strategy, with aligned commissioning standards and contribution standards.

·  Consider options for high level implementation and resource phasing.

·  Develop an Integrated Care System-wide financial and risk management strategy for Intermediate Care provision

Resolved:  That the Health and Wellbeing Board:

(i)  Noted the progress of the Intermediate Care Programme to date.

(ii)  Agreed to act as the accountable body for this programme.

(iii)  Agreed to hold the Integrated Care System to account for implementing via the Integrated Care Partnerships.

(iv)  Agreed to work with other Health and Wellbeing Boards (Blackburn with Darwen, Blackpool and Cumbria) to undertake that assurance role akin to a committee in common approach.

(v)  Agreed to a review of the Advancing Integration Board membership that will function as a Programme Board.

(vi)  To provide the check and challenge to the programme at key intervals linked to decision gateways.

(vii)  Recognised and lent support for the need for this programme to be properly resourced at Integrated Care Partnership and Integrated Care System levels.

(viii)  Endorsed the link with Population Health Management and Continuing Health Care programmes of work.

(ix)  Requested that this be brought back to the next meeting by Louise Taylor, further to discussion with the Senior Leadership Executive.