Agenda item

A report requesting approval of the final version of the updated Better Care Fund Plan for 2024/25, along with a request to note the Addendum to the Better Care Fund Policy and Planning Requirements for 2024/25.

The Sub-Committee received a report which outlined the Addendum to the Better Care Fund Policy Framework for 2024/25.

Rachel Briden, Integrated Partnership Manager, introduced the report which summarised the Better Care Fund Plan submission for 2024/2025.   She reminded Members that the 2023-25 Plan had been previously approved, however, there was now a requirement to submit any changes from the original for 2024/25.

Rachel Briden signposted Members to the Better Care Fund Planning Template 2024/25 attached as an appendix to the report.  The deadline set for submission had already passed on 10 June 2024 but HWBB Sub Committee approval, post submission, was acceptable, with any amendments raised to be resubmitted after the meeting.  In short, the appendix detailed the finances, metrics and capacity and demand as the three key areas of focus.

Members noted the four National Conditions detailed at section 1.6 of the report along with the funding contributions table at section 2.2.  The table detailed the increased allocation for the Disabled Facilities Grant, the ICB Discharge Fund and WCC Aligned Budgets.

The report highlighted the timescales to which the partner meetings and boards had received the plan and provided assurance of the governance processes that would be followed.  It was hoped that formal approval letters from NHS England would be provided by the end of July 2024.

Rachel Briden gave a thorough overview of the planning template, explaining in detail the different sections and the information contained within each one.

Councillor Bell raised a query relating to the Capacity and Demand details on page 19 of the pack.  This showed a deficit for pathway 1, ‘Reablement & Rehabilitation at home’ and Councillor Bell asked what the impact would be if the shortfall was not met.  Rachel Briden advised that conversations were ongoing with the ICB around the shortfall and impact.  Additional funding from NHSE had been forthcoming last year as part of the national front runner pilot, but ultimately the impact may be that patients stayed in hospital for longer.

It was also noted that patients on Pathway 1, if impacted, may be able to access Pathway 2, ‘Reablement and Rehabilitation in a bedded setting’.  Nigel Minns reminded Members that demand was not steady throughout the year and was impacted by peaks and troughs, which would also reflect on capacity levels at times.

Councillor Bell queried the accuracy of some of the figures in the ‘Demand – Hospital Discharge’ table.  She was advised that the figures were based on acute plans but it was difficult for the ICB to breakdown the Coventry and Warwickshire patient numbers.

The capacity and demand figures for the Community pathways were discussed along with the different finance streams and updated outputs for 2024 to 2025.

Councillor Roodhouse asked for clarification on how the changes to budgets were agreed between the ICB and WCC.  Rachel Briden explained that the figures were prepared by the Finance Sub-Group to the Joint Commissioning Board before being agreed.  She highlighted that the base budgets had increased as a result of inflation, with all schemes still running.

Members were signposted to two new schemes detailed on 28 of the pack – W-IBCF 24 Market Sustainability and Discharge Fund – Additional Social Care Capacity.  Councillor Bell asked if it was accepted that a person in a hospital bed cost more than them being located anywhere else.  Rachel Briden felt it was accepted but the challenge was that the bed could always be filled by the acute service.  Therefore, focus needed to be on the admission avoidance work.

Councillor Roodhouse raised a point relating to the amount of time and hours taken to produce this analysis and the subsequent value of the information.  Officers explained that the process highlighted demand and capacity and showed where the money was being spent.  Warwickshire was very transparent in its reporting on spending and was one of the higher performing areas in terms of discharges to the patient’s usual place of residence.

The costings in residential care homes were discussed, along with how the type of care had changed over time and the specialist care often needed overnight.  The issue of falls was also raised as being a main reason for admission to care homes.  In response to a question from Councillor Roodhouse regarding local authority joined up working, Rachel Briden agreed to progress the promotion of Fall Prevention campaigns with the Housing Partnership Board.

The report went on to detail the Metrics for 2024/25 and Councillors discussed how a judgement was made relating to the ‘Avoidable Admissions’ data.  Rachel Briden suggested it may be total admissions figure minus planned admissions but offered to get clarification.

Rachel Briden concluded the report by explaining that any feedback or questions would come back to the Health and Wellbeing Board.

Councillor Bell thanked Rachel Briden and all the officers involved for their input and recognised the amount of work required to produce this report.

Councillor Bell proposed the recommendations as laid out and this was seconded by Councillor Roodhouse.  It was, therefore,

Resolved that the Health and Wellbeing Board Sub-Committee:

1)    Notes the Addendum to the Better Care Fund Policy and Planning Requirements for 2024/25;

2)    Notes that the previously approved and assured Better Care Fund Plan for 2023-25 and this updated Better Care Fund Plan for 2024/25 contributes to the wider Health and Wellbeing Board’s prevention priorities as well meeting the Better Care Fund national conditions; and

3)    Approves the final version of the updated Better Care Fund Plan for 2024/25, in line with the recommendation and delegation of the Health and Wellbeing Board on 23 September 2015, as submitted to NHS England on the 10 June 2024.

   The meeting rose at 10:12am