Agenda item

Purpose: To receive the six-monthly report on the Better Care Fund.

Paul Coe (Executive Director, West Berkshire Council) presented the report on the Better Care Fund (BCF), a pooled budget designed to ensure effective collaboration between local authorities and health partners. The fund aimed to improve outcomes by focusing on reducing hospital admissions, facilitating timely hospital discharges, and preventing unnecessary admissions to care homes. The report highlighted the current performance against national metrics, challenges with data reporting, and the impact of recent disruptions, such as the insolvency of the equipment provider NRS.

During the debate the following points were discussed:

·         It was raised that the BCF played a critical role in supporting integrated health and social care services, but there were ongoing challenges with data reporting, particularly around delayed discharges and emergency admissions. Helen Clark (Associate Director of Place, Bob ICB) explained that local reporting had been replicated by the Frimley analytics team, which was expected to resolve some of the data gaps. However, national dashboards for the BCF remained under development.

·         A question was asked about the impact of the insolvency of Nottingham Rehab Services (NRS) on hospital discharges. Barbara Billett (Quality Assurance Manager, West Berkshire Council) explained that the insolvency caused significant disruption to the provision of equipment and adaptations needed for hospital discharges. A new provider, Millbrook, had since been contracted, and services have stabilised, but the disruption contributed to delays during the transition period.

·         It was discussed that West Berkshire was performing well in preventing care home admissions, with effective use of "Pathway 3" discharges, which focussed on supporting individuals to return home with appropriate care packages rather than moving into residential care unnecessarily.

·         A question was asked about the potential for using the BCF to fund preventative measures, such as smoking cessation and health checks, particularly in rural areas. Paul Coe noted that while the BCF was a valuable resource, its use was subject to strict guidelines, and funding could not be allocated to statutory functions already required of local authorities. He emphasised the need to balance statutory responsibilities with value-added activities.

·         It was raised that the BCF should be used to address local needs, including support for carers and voluntary sector initiatives. Helen Clark noted that the ICB was mapping patient journeys to identify bottlenecks and areas for improvement in hospital discharge processes, which could inform future use of the BCF.

·         A concern was expressed about the importance of keeping people out of hospital and promoting public health initiatives. Paul Coe reiterated that while the BCF was focused on integration and improving outcomes, there were limitations on how the funding could be used, particularly for activities that fall under statutory responsibilities.

·         It was discussed that the BCF budget was on track, with a small underspend anticipated. This underspend could be carried forward to the next financial year, ensuring that resources were available to address ongoing challenges.

The committee would receive a further update on the Better Care Fund in six months.