Report of Strategic Programme Manager, Integration, Adult and Health Services, Durham County Council.
The Board received a report of the Strategic Programme Manager, Integration, Adult and Health Services relating to the Better Care Fund Policy Framework and Planning Requirements 2021-2022 (for copy see file of minutes).
The Strategic Programme Manager, Integration, Paul Copeland noted the report gave a summary of the policy framework and planning requirements for the Better Care Fund (BCF). He added that the Board would be aware that it was a national initiative for driving health and social care integration, in a way that supported person-centred care, sustainability, and sought to improve outcomes for people and their carers. He explained that the BCF was launched in 2015 and established poolled budgets between the NHS and Local Authorities, with the aim to reduce the barriers often created by separate funding workstreams. The Strategic Programme Manager noted that in 2021/22 there were minimal changes for the BCF, given the ongoing pressures associated with the pandemic. He explained the policy framework outlined a 3.5 percent national uplift, with some variation on that figure in parts of the country, as in previous years. He added that in County Durham it had been agreed by the Health and Social Care system for a 5.3 percent uplift.
The Strategic Programme Manager noted the main policy requirements for the BCF 2021/22 were largely unaltered and addressed at paragraph 12 of the report. In relation to the Plan, he explained that considered of a narrative plan and a BCF planning template which outlined income and expenditure and national metrics. He noted national metrics were outlined at paragraph 18 of the report and included: effectiveness of re-enablement of people at home 91 days after being discharged from hospital in receipt of re-enablement; permanent admissions of older people to residential or nursing home care; and three new metrics. He added those three new metrics related to: avoidable hospital admissions; reducing length of stay for those in hospital longer than 14 and 21 days; and the proportion of people discharged home to their usual place of residence.
The Strategic Programme Manager noted that the BCF planning template and assurances did not coincide with the Health and Wellbeing Board schedule of meetings and as a result there was a request made for delegated authority for sign-off by the Chair and Vice-Chair of the Board, which was subsequently agreed. He concluded by noting that the Plan was submitted to NHS England on 16 November 2021, with scrutiny to be via regional assurance by 7 December, followed by cross-regional assurance by 9 December and with final approval by NHS England by 11 January 2022.
The Chair asked if we could guarantee that County Durham would not lose any of the Better Care Fund and asked what we were doing to influence decisions at the regional level. The Strategic Programme Manager noted he could not guarantee that County Durham would lose any of the BCF in the future, noting that while nothing would change for the 2022/23 year, he noted beyond that was not known. He noted that the BCF had been one of the most protected integration initiatives of recent times and would be difficult to unpick.
He noted that in terms of influencing decisions at a regional level, he understood that Senior Officers of the Council were involved in regional discussions and that the previous item relating to Health and Social Care Integration presented by Michael Laing had provided an overview of future developments.
(i) That the report be noted.
(ii) That a full copy of the BCF Plan was available from the Strategic Programme Manager be noted.
(iii) That the Board receive further BCF updates at future Health and Wellbeing Board meetings.