Agenda item

Stephen Beet gave a presentation on this issue and made the following points:

·       The Better Care Fund is a vehicle for driving health and social care integration.

·       The ICB and Bristol City Council were required to agree a joint plan overseen by the Health and Well Being Board

·       The Joint Plans would use a pooled budget to support integration through a Section 75 agreement

·       There were three main components to this – a minimum  contribution to the ICB, £13.5 Million to be spent on adult social care related to funding adaptations and an improved Better Care Fund which would not exclusively be from the NHS and therefore improve flexibility

·       There were four conditions – A Joint agreed plan on HWBB to be signed off, an NHS contribution for adult social care at HWBB level, home care temporary beds and a greater focus on the Home First agenda

·       A list of performance indicators that needed to be included were set out

·       One of the main targets was to reduce the number of avoidable admissions to hospital via bedded care homes

·       The Better Care Fund had been in operation since 2013 and had bene linked to certain budgets. Following a review in 2022/23, it was now important to make sure these were focused on particular projects such as new transformation projects

·       Work was being carried out with the ICB to reprofile expenditure

·       There was also a focus on intermediate care such as work funded through the Local Authority and other services subject to social work capacity such as We Care Hospital and the Handy Person Service

·       On Thursday 17^th November, the anticipated £500 Million Discharge Funding had been confirmed in the Autumn Statement and received. It had been split 60/40 between the Local Authority and the ICB to prioritise home care

·       The Winter Fund had been pooled into the Better Care Fund and agreed by Local Authorities as part of the Integrated Care package. There was a requirement to complete a capacity tracker with a progress review in January 2023

·       The Board was requested to delegate to the Chair the power to approve the document by 16^th December 2022 and report back to January 2023 Board meeting

Board members made the following points and Stephen Beet responded as required:

·       Consideration should be given to creating a Sub Group between partners in this area

·       Whilst this work sounded great, this had the potential to create a big strain on resources. Consideration need to be given to change to align services better

·       Whilst there remained some lack of alignment with need, the BCF remained a good financial vehicle for delivery. There was a need to discuss with Locality Partnerships how additional funding could be provided to them

·       It was noted that BCF was very highly performance driven and that therefore local assessment was being carried out even though it was not specifically required

·       Whilst the allocation formula was focused on need, this did provide a bigger share of resources. It was important to assess how other parts of other parts of the country were carrying out this work and to prioritise

·       This showed the strength of the resources available. It was important to focus on hospital discharge and providing suitable accommodation. The constraints on health and social care were acknowledged but funding services could be used in specific situations, such as ensuring people’s homes were safe

·       The Work Programme included a discussion on extra care and housing sine there was a need to address the issue of pathways out of hospital for patients

·       A summit would be carried out shortly for care homes involving a collaboration across the Voluntary Sector

RESOLVED:  that the Board supports the 2022/23 BCF (Better Care Fund) which was submitted on 26th September 2022 and agrees to delegate to the Chair of the HWBB (Health and Well Being Board) the authority to approve the submission of a plan for £1.69 Million of Discharge Funding by 16th December 2022 and report back to a future HWBB on plans for BCF to the Board

ACTION: Stephen Beet