Agenda item

Purpose: To seek agreement to the West Berkshire Locality Plan for 2016/17 and make a recommendation to the Council’s Executive.

The Board discussed a report (Agenda Item 3) regarding the Better Care Fund 2016/17, a government initiative established to fast track integration with Health and Social Care. The first year of implementation was 2015/16; all Councils and Clinical Commissioning Groups (CCGs) had to agree a plan and then obtain approval from their Health and Wellbeing Boards. 

The government had confirmed a continued commitment to the initiative, therefore all Councils and CCGs were required to have a plan for 2016/17 and obtain approval from their Health and Wellbeing Boards.

In common with the previous year there were a number of national conditions that plans had to meet. Importantly for the local authority ‘Maintaining the provision of social care services’ had been retained with the requirement that it would be at least the same or a real terms increase.

The Department of Health (DofH) had also confirmed that the Social Care Capital Grant would be discontinued from 2016/17 and instead had combined the Disabled Facilities Grant (DFG) and Social Care Capital Grant into one in order to maximise value for money. DofH research suggested the DFG could support people to remain independent in their own homes – reducing or delaying the need for care and support, and improving the quality of life of residents.

Nationally, there had been an average 11% increase in the capital allocations of the DFG. West Berkshire was an outlier receiving a 39% increase.  Alongside this funding increase the BCF plan now included a requirement to confirm how the Council plan to use the grant in the coming year.

The Better Care Fund allocation for the West Berkshire Locality had been confirmed as just over £10.6m; this represented a 1.9% increase on the value the previous year. The allocation for social care was £4.367m, a real terms increase on the allocation of £4.021m in 2015/16.

The CCG and the Local Authority had agreed a plan that would allow the continuation of the West Berkshire Better Care Fund projects such as the Joint Care Provider scheme, seven day week services and maintaining the existing capacity within the reablement service. It would also allow the Council and CCG to continue to support the West of Berkshire projects. 

This work would support the Council and CCGs to continue to improve performance on Delayed Transfers of Care and reduce Non-elective admissions; key objectives of the Better Care Fund.

The CCG and the local authority had been able to agree a Better Care Fund plan that both met the national conditions and importantly would improve health and care services for local residents. Therefore it was recommended that Members agree the plan as outlined in the report and recommend it to the Council’s Executive.

Councillor Gordon Lundie enquired why West Berkshire had received a nearly 40% increase in the DFG, which seemed disproportionately high. Tandra Forster responded that historically West Berkshire had received a higher DFG allocation than other local authorities, perhaps because it did not have its own housing stock. The BCF included more requirements around transparency and so it would be clear how the DFG was spent.

Tandra Forster advised that since the report was published, the submission deadline had been moved to 3^rd May 2016 but officers planned to work to the reported timeframe of submission by 25^th April 2016. New metrics had been introduced for delayed transfers of care and non-elective admissions; further work was ongoing in conjunction with the Berkshire West System Resilience Group.

The first two submission timeframes had been met, including the submission of the plans and the narrative. Partial assurance had been received on the narrative and further work was required on the narrative for delayed transfers of care.

Shairoz Claridge advised that further detail was also required in the narrative for seven-day working, dementia and reablement which would be included by 25^th April 2016.

Tandra Forster commented that the National Health Service had worked well with the Local Government Association and Association of Directors of Adult Social Services; the process for agreeing the BCF had been very supportive.

Councillor Lundie, referring to the table on page 64 of the agenda, advised that there was a reported £462k underspend from 2015/16 included under the Local Authority contribution for 2016/17. He noted however that on page 65, it was explained that following a change of direction and redesign in relation to one of the West of Berkshire projects some funding allocated to help social care manage the impact was not utilised. He therefore asked whether this might be considered to be a ‘slippage’ due to projects being delayed rather than an underspend. Tandra Forster explained that apart from the capital funding, the rest of the BCF 2016/17 was from the CCGs. The £462k was part of the original funding in the previous financial year and did not relate to the Council’s funding of the BCF. Shairoz Claridge commented that due to different financial rules effecting the CCGs, had the money not been held by the Local Authority as an underspend, it would have been returned to NHS England and allocated to another locality.

Referring to page 72 of the agenda on developing an integrated health and social care system by 2020, Councillor Lundie expressed the view that the footprints of Sustainability and Transformation Plans would have a big impact on health and social care integration and Members of the Board needed to be sighted on these. Tandra Forster advised that plans were at an early stage but there would be an item brought to the Board at the meeting in July 2016 on the subject. West Berkshire would come under the Buckinghamshire, Oxfordshire and Berkshire West footprint and there would be an impact on how services were planned. Changes to funding would cause risk to the system, as budget surpluses could not be created.

Shairoz Claridge further explained that the plans would be dependent on contract negotiations with providers. She confirmed that it was hoped that Cathy Winfield and Nick Carter could jointly present information on the Accountable Care System and Sustainability and Transformation Plans at the meeting in July 2016. Tandra Forster commented that a meeting had already taken place and information was being compiled about what services could be provided at scale and how a resilient system could be developed. A workshop would be taking place on 4^th May to further develop the plans.

Councillor Lundie noted that Nick Carter had proposed that Cathy Winfield attends a Strategy Board meeting to discuss the Sustainability and Transformation Plans.

Turning to page 89 of the agenda, Councillor Lundie asked how West Berkshire was performing regarding discharging patients at the weekend. Tandra Forster advised that the target relating to seven-day working had been met. The Royal Berkshire Hospital performed very well but other hospital used by West Berkshire residents, in Swindon and Basingstoke, were struggling because they found that patients were more unwell and there was no easy access to home care.

Councillor Graham Jones proposed that the Board approve the Better Care Fund plan 2016/17 as laid out in the report and subject to the amendments as discussed. Dr Bal Bahia seconded the proposal. The Board voted on the matter and unanimously approved the Better Care Fund plan 2016/17.

RESOLVED that the Health and Wellbeing Board approve the Better Care Fund plan 2016/17 and recommend it to the Council’s Executive.