Agenda item

To receive a report for information reviewing the 2015-16 Better Care Fund. 

To consider a report on the Better Care Fund Plan for 2016-17. 

The Board received a report from Bindi Nagra, Assistant Director of Strategy and Resources – Health, Housing and Adult Social Care and Graham MacDougall, Director of Strategy and Partnerships, Enfield CCG. 

Keezia Obi, Head of Service Enfield 2017 (BCF Lead), presented the report to the Board highlighting the following: 

·         The report was in two parts.  A review of 2015/16 and the plan for 2016/17. 

·         The Overview of 2015/16 highlights the achievements in relation to admissions to residential and nursing care, integrated locality team working and community based rapid response working as well, as the  challenges faced over delayed transfers of care  and in Non-Elective (emergency) admissions (NEA’s) to hospital. 

·         In response to recent audits, governance and management of the fund had been strengthened recently.  The financial issues were mainly historic and were in the process of being resolved.

NOTED

1.            Activities had been put in place for improving integrated care for the over 50s.

2.            The new Older People’s unit at Chase Farm had been successful and was well used.

3.            Work was continuing with GPs to expand 7 day working using the integrated locality teams.

4.            Funding for IAPT (Improving Access to Psychological Therapies) had been expanded.

5.            A programme had been set up for enhanced behavioural support which would be continued into the next year. 

6.            Much had been achieved in the past year although there was still more to be done. 

7.            The guidance from NHS England for developing the new plan had only recently been received.  The conditions were in the main the same as last year, except for two which are noted in the report – a plan for DTOC’s and removal of performance payments related to NEA’s which has been replaced by the consideration of a risk sharing agreement..

8.            The final submission was due by 3 May 2016.

9.            The narrative plan had been included with the agenda pack and included agreement on issues such as the alignment and extension of memory clinics, 7 day working and support for mental health.

10.         Ninety five percent of the investment plan had been agreed, but discussions were continuing on the final 5 %.  It was noted that the area that remains unresolved is due to the CCG being unable to commit further funds due to financial pressures and the Council wanting to see further investment in the community funded by the BCF.

11.         Outstanding issues were around the investment plan funding and the risk share agreement.  Both the local authority and the NHS were suffering from severe financial challenges.  Agreement will be reached by the deadline.  If necessary an escalation process will be used to ensure agreement. 

12.         Acknowledgement that it was disappointing that agreement had not been reached, but it was agreed that the Chair and the Vice Chair would sign off the final submission once an acceptable reconciliation had been brokered. 

AGREED: 

1.            To note the update on the 2015-16 Better Care Fund (BCF) plan, including the current performance metrics and achievements.

2.            To note the activity taking place in response to participation in the NHS England support scheme and audits, in particular improvements being made. 

3.            To note the publication of the 2016-17 planning guidance and timetable, and key changes to last year’s guidance.

4.            To receive the attached Better Care Fund 2016-17 narrative plan (submission 2 as noted above), noting that this may be subject to change as a result of the final agreement to the investment plan.

5.            To agree that delegated authority is given to the Chair and Vice-Chair of the Health and Wellbeing Board to approve that the final 2016-17 Better Care Fund submission.  This is in view of the very tight timescale and that the Council and Clinical Commissioning Group have not yet reached agreement on the investment plan.

6.            To note at the time of writing that on 11 April 2016 we received verbal feedback from NHS England on the second Better Care Fund submission, but are awaiting the formal feedback. The summary feedback is that we have a good plan but a rating of ‘approved with support’ has been given at this stage in view of the area awaiting resolution. Further details have been included in the report, but it is noted that it may be subject to change.

7.            To note that since the last report to the Health and Wellbeing Board in February, a further development session had been held with the Integration Board.