Agenda item

A report requesting approval of the final version of the Better Care Fund Plan for 2023-25 submitted to NHS England on 28 June 2023; along with a request to note the Better Care Fund Policy Framework and Planning Requirements for 2023/25.

The Sub-Committee received a report which outlined the Better Care Fund Policy Framework and Planning Requirements for 2023/25. 

In addition, the report highlighted the Better Care Fund Narrative Plan and Planning Template for 2023-25 which contributed to the wider Health and Wellbeing Board’s prevention priorities as well meeting the BCF national conditions.  Members were also asked to approve the final version of the Better Care Fund Plan for 2023-25, as submitted to NHS England on the 28 June 2023.

Rachel Briden, Integrated Partnership Manager, introduced the report and thanked officers for arranging the meeting.  She explained the timescales involved, the need for a sub-committee to be held and summarised the presentation she would deliver.

The presentation gave an overview of the current position of the Better Care Fund, the Better Care Fund plan, key areas of focus and links to NHS activity and summarised the recommendations being considered.

Members were reminded that locally the Better Care Fund (BCF) was delivered through the ‘umbrella’ of the Better Together Programme and that the Joint Commissioning Board had oversight of it.  Officers explained the pooled contributions and how these were split between funding for core NHS and local authority services and those funds received directly by the local authority.

The BCF Programme for 23-25 was explained and included Transformation Activity and projects that were known to Members.  Members noted that the majority of the funding into the BCF was NHS budget with national conditions applying to £71 million, specifying what services had to be funded and ensuring there was transparency on spending.

Councillor Bell highlighted the schemes being delivered through the Improved Better Care Fund (IBCF) and signposted Members to the appendices of the report for further detail.  Officers confirmed the IBCF was not permanent but was being provided on a one year rolling allocation.

Direct funding to District and Borough Councils was discussed and it was noted that some of this was based on need, population and other factors.  Whilst the Disabled Facilities Grant allocations were set nationally, they were pooled under the Home Environment Assessment and Review Team (HEART) Partnership.  Following a question from Councillor Bell, officers confirmed that monitoring of expenditure was undertaken by the HEART Board.

Slide 4 of the presentation advised that the majority of the NHS contribution in the pooled budget funded core local authority and NHS services, most of which had been in place since 2016.  The budget for each service was broken down and information provided as to whether this was delivered by the NHS or the local authority.  Officers stated that there had not been an inflation increase to the Improved Better Care Fund for a couple of years and this had added to the cost pressures.

Councillor Roodhouse asked for clarification on the current position with Continuing Health Care (CHC) and was advised that a review and redesign was planned between 2023 and 2025.  Officers assured that this was in the plan as a commitment with a report to be considered shortly.  The focus of the work was how CHC was being delivered, whilst exploring opportunities for functions to be delegated to care collaboratives.

Ali Cole, Head of Commissioning – Health and Wellbeing, addressed the meeting and explained the monitoring processes which were managed through regular data returns to the NHS.  There was an increased focus nationally on capacity and demand along with a focus on intermediate care, wraparound services, understanding need and how capacity could be managed during seasonal changes. 

Members sought clarification on the visibility of the data for District and Boroughs and the aim to relaunch a representative from the housing board on the Joint Commissioning Board to help re-establish links.  Ali Cole advised that a new discharge metric was due to be announced shortly but officers were still waiting for further detail.

The presentation outlined key areas of joint focus including Discharge to Assess and Community Therapy.  The development of therapeutic services and supporting patients at home was noted, however, it was acknowledged that this could be a challenge due to the work force issues.  Councillor Bell questioned whether appropriate facilities existed in the north of the County and Rugby and was keen that step-down facilities were available with therapists to enable people to be discharged for interim care. 

Under the Ageing Well Programme, officers drew attention to the Urgent Community Response programme which it was felt should be celebrated and also noted that the Dementia Strategy was due for sign off by the ICB shortly.

The Chair applauded the officers for such an in-depth piece of work and acknowledged how much was involved.  Councillor Bell then outlined the recommendations in the report.

Councillor Holland also noted the level of work and the opportunities this could bring.  He referred to the need to be certain of demand levels as well as the ever-changing use of technology to support care services.  He raised a concern that there was uncertainty about long term funding but the duty to Warwickshire residents was to focus on the quality of care and not dilute the support too widely. 

Councillor Bell agreed with the concerns raised about resource and increasing demand but hoped that early intervention with patients was key.  She felt that concentrating on care at home continued to be the right thing to do.

Having considered the report and having heard from the officers present, it was

Resolved that the Health and Wellbeing Board Sub-Committee:

1)    Notes the Better Care Fund Policy Framework and Planning Requirements for 2023/25;

2)    Notes that the Better Care Fund Narrative Plan and Planning Template for 2023-25 contributes to the wider Health and Wellbeing Board’s prevention priorities as well meeting the BCF national conditions; and

3)    Approves the final version of the Better Care Fund Plan for 2023-25, in line with the recommendation and delegation of the HWBB on 23 September 2015, submitted to NHS England on the 28June 2023.

The Chair thanked everyone for attending.

The meeting ended at 14:17

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Chair