Agenda item

Adult Social Care Discharge Fund 2022/23

For the Health & Wellbeing Board’s Sub-Committee to note the conditions and reporting relating to the Adult Social Care Discharge Fund 2022/23 and to consider and approve the proposed local split of funding.

Minutes:

Rachel Briden (Integrated Partnership Manager, Adult Social Care) introduced the report which asked the sub-committee to note the conditions and reporting requirements relating to the Adult Social Care Discharge Fund 2022/23 and to support the scheme and areas of focus for submission to NHS England and the Department for Health and Social Care.

 

Rachel Briden advised that following the announcement by the DHSC in September, details of the Adult Social Care Discharge Fund had been published on 18 November 2022.  It was noted that the allocation to Warwickshire County Council Adult Social Care was £1.862m and to the NHS Coventry and Warwickshire Integrated Care Board (ICB) was £6.715m. Members were advised that since the publication of the report, updated and finalised figures had now been agreed with the Integrated Care Board, replacing some of the expected or estimated figures in the report. 

 

Members were signposted to the revised figures throughout the report and each revision was explained in full by officers.  Rachel Briden explained that there were conditions attached to the funding, which would be used for discharge activities in order to free up acute beds and reduce patients’ length of stay in hospital.  The allocation of funding had been jointly agreed with the Council and the ICB and met the Health and Wellbeing Board’s (HWBB) priorities.

 

It was noted that the allocation of the £6.715m referred to in paragraph 1.5 for Warwickshire would be £4.095m, to be split between social care and NHS activities.

 

In addition, the table detailed at paragraph 1.6 had been updated as follows:

 

 Strategic Objectives and Conditions which the scheme relates to

Estimated Scheme  Cost 

Home Care or Domiciliary Care

£1,286,083

Residential & Nursing Placements

£2,123,216

Domiciliary Care and Reablement in a Person's own Home (Rehab at Home)

£296,520

Other

£383,652

Assistive Technologies and Equipment

£123,200

Bed Based Intermediate Care Services

£336,333

Increase hours worked by existing workforce

£1,247,592

Reablement in a Person’s Own Home

£18,000

Local recruitment initiatives

£0

Additional or redeployed capacity

£146,000

Total

£5,960,596

 

Following a question from Councillor Bell, clarification was given on the Home Care allocation of £1.286m which had reduced from the original report.  It was hoped this would fund the shortfall from the hospital discharge fund which was a cost pressure for the Council at present.  In response to further questions, it was confirmed that there would be no financial assessment of patients at the point they left hospital and they would leave with a package of care.  Any assessment would be completed outside of the acute setting and completed as soon as possible thereafter.

 

Officers also confirmed that they had enough staff to be able to carry out the assessments but highlighted that this funding was only available to the end of March 2023.

 

In relation to the Domiciliary Care and Reablement in a Person’s Home, this service included the need for a physiotherapist or occupational therapist to attend the patient in their home or usual place of residence.  It was noted that officers were looking at the number of therapists available and were working with the lead officer to mobilise this scheme.  Councillor Humphreys highlighted the importance of this service in the community and expressed a desire to raise the profile of this valuable work.

 

The figure detailed ‘Other’ in the table related to the ICB’s costs to cover the delivery of the scheme and the ongoing monitoring that would need to take place.

 

Rachel Briden advised that the Assistive Technologies section often included additional vans, drivers and equipment and highlighted that there was a lack of specialist wheelchairs to support discharges for Stroke patients in Warwickshire.  The additional funding should enable further purchases to be made and it was noted how important assistive technologies were in enabling patients to return to their homes.  Councillor Humphreys reinforced this point by referring to specific stroke patients’ circumstances in her ward.

 

Following a question from Councillor Bell relating to the Bed Based Intermediate Care Services, officers advised that commissioners would identify where the beds would be located.  Market testing had been carried out and the aim was for the service to be provided across the County and deliver a wide spread and good access.  Members were keen that balance was achieved because some patients did not want to have to travel to the south of the County.  Councillor Humphreys referred to the closure of the facility at Bramcote which she felt should have remained open.

 

The figure allocated to the ‘Increase Hours worked’ referred to the funding of additional agency staff and the community bed based support staff costs.  Whilst a specific breakdown of the figures was not available, Rachel Briden advised this could be shared outside of the meeting but the aim was to cover all additional NHS staffing costs.

 

In relation to the lower figure allocation to the ‘Reablement in a Person’s Own Home’, it was noted that this had incorrectly been added as a whole year cost rather than only up to the end of March 2023.

 

An additional line had been added to the table entitled ‘Additional or redeployed capacity’ which aimed to provide additional support for the domiciliary care market and the redeployment of staff.

 

The Chair then invited the Healthwatch representative, Chris Bain, to address the meeting and raise any further points he may have.  Chris Bain advised that he felt this was a well structured package and Councillors had covered all the points he wished to ask.  Councillor Bell was pleased that the funding would be in place in the areas detailed and hoped this could provide an opportunity to look at some pilot schemes.

 

Rachel Briden outlined how the governance of the funding and schemes would work and advised that the deadline for signing the BCF section 75 agreement had been extended to 31 January 2023.  Due to the inclusion of updated figures, the financial implications section of the report had been revised to reflect the total allocation of funds as £5,960,596 to be spent by the end of March 2023.  Members noted that the funding would be provided in two tranches and fortnightly reporting conditions would be in place.

 

In addition, the HWBB would receive a further update at its meeting in January 2023 along with the minutes of this meeting.

 

Having considered the report and having received clarification on a number of points, the Chair proposed the recommendations based on the revised figures presented.

 

Resolved

 

That the Health and Wellbeing Board Sub-Committee

 

1)    Notes the conditions and reporting requirements relating to the Adult Social Care Discharge Fund 2022/23 and that decisions relating to this funding will be made in accordance with existing Better Care Fund governance;

2)    Supports the schemes and areas of focus set out in the Adult Social Care Discharge Fund Plan for 2022/23 for submission to NHS England and the Department for Health and Social Care;

 

3)    Authorises the Strategic Director for People to agree and finalise the Adult Social Care Discharge Fund Plan for 2022/23 in consultation with the Chief Executive Officer of NHS Coventry and Warwickshire Integrated Care Board; and

 

4)    Notes that a further update will be provided to the Health and Wellbeing Board on the 11 January 2023.

 

 

 

 

The meeting rose at 12:12

 

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