Agenda item

Mark Tyson, Group Manager, Integration and Commissioning, LBBD, and Sarah de Souza jointly presented the report, which gave a re-cap of the performance during 2015/16 and also built upon the details reported in December 2015.  The eleven schemes within the Better Care Fund (BCF) had delivered most of the key milestones that had been set out in the BCF plans submitted to NHS England, however, there had been some under achievement on a number of metrics, the full details of which were set out in the report.

The BCF plans for 2015/16 and the associated Section 75 Agreement and pooled budget arrangements would come to an end on the 31 March 2016. The Policy Framework for 2016/17 had been released in January 2016 and the further technical guidance had been received in February, which had enabled work to start on the development of BCF plans for submission to NHS England.  Mark drew the Board’s attention to its role in approving the BCF plans before submission and to the timeframe that set out the final BCF plan submission date for 2016/17 as the 25 April.  As the Board was not scheduled to meet until the 26 April, officers had suggested that NHS England is informed that the BCF 2016/17 Plan will be formally signed off by the Board on 26 April and submitted on 27 April rather than being approved through delegated authority.

Mark drew the Boards attention to the expected financial arrangements for 2016/17, set out in Appendix A of the report, and explained that this together with the Ambition 2020 Programme, planning guidance from NHS England and the emphasis in shift towards delay transmission of care would all impact on the final 2016/17 plans and targets. 

Discussion was held in regards to a number of areas of performance concern and the actions that would be needed to address those and other issues, including:

·  The need to be realistic about what could be achieved with reducing budgets when there was both an increase in population numbers and a growing ageing population.

·  That only half of people discharged felt significantly supported to manage their own conditions, with mental health discharge being a significant part of the non achievement target.  Consideration needed to be given by Partners into what could be done in regards to aftercare that would then enable people to feel safe and supported enough to manage their own condition.

·  The overspend last year was indicated at around £600,000 but this was now expected to be a £200,000 overspend.  Consideration would need to be given to the permanent base budget and the effect of this on services.

·  The Healthwatch review had raised the issue of the four to six month wait for suitable housing for people being discharged and the effect that this could have on their health and rehabilitation.  The Chair reminded the Board that this was discussed at the last Board meeting.  There was pressure on the local housing market because of the lack of suitable housing stock / social housing and cost of private rental.  This pressure was being looked at as part of the Housing and Homelessness Strategies. 

·  The need to ensure that data was robust to enable proper planning and monitoring and the work that was being undertaken with BHRUT to ensure that individuals were being identified.  The Chair drew the Board’s attention to self-funders and how they could be identified and included, so that true comparators and trends could be assessed.

·  Wider integration approaches, including the Sustainability and Transformation Plan (STP) and the need to ensure that partner priorities and requirements were reflected in the development of the Accountable Care Organisation (ACO) business case.  Whilst the BCF was a national programme it is developed and delivered locally and should become part of the ACO business case.

The Board:

(i)  Noted the progress made in 2015 and the process for drawing up the 2016/17 Better Care Fund (BCF) plan, including the Board’s role in approving the BCF plan;

(ii)  Noted that the Policy Framework for the 2016/17 BCF had been released in January 2016 and the technical guidance had been received in February 2016, which had had a significant effect on the timetable for producing the BCF plan;

(iii)  Endorsed, in principle, the current draft BCF plan, extension of the current Section 75 Agreement into 2016/17 and budget for 2016/17, which was set out in the Finance report to Joint Executive Management Committee attached as Appendix B to the report, and agreed this should be used for the initial submission, albeit that some amendment would be likely as the plan was finalised; and

(iv)  Agreed that in view of the timetable constraints, the Draft Final Plan should be submitted to NHS England on 25 April 2016 and that NHS England would be advised that the Plan was to be considered by the Board at its 26 April 2016 meeting, with the aim that the final Plan would be provided to NHS England on 27 April 2016.