Agenda item

Kate Green, Policy Officer, and Tom Cray, Strategic Director, Neighbourhoods and Adult Services, presented a report on the Better Care Fund and how Rotherham had developed a local plan to meet its requirements.

The Fund was announced by the Government in June, 2013, the spending round providing a catalyst for local authorities and Clinical Commissioning Groups to transform and integrate health and social care.  It did not offer any new money but provided a single pooled budget made up of money already in the system to support health and social care services to work more closely together in local areas.

The local plan had been developed by a small multi-agency task group of the Health and Wellbeing Board supported by an officer group and contributed to achieving the overarching vision of the Health and Wellbeing Board i.e. “to improve health and reduce health inequalities across the whole of Rotherham”.

The action plan (Appendix 2) demonstrated the specific actions that would be delivered locally as part of the Better Care Fund.  The actions were aligned to the 4 strategic outcomes of the Health and Wellbeing Strategy as well as demonstrating how locally they contributed to the 6 national conditions. 

Locally plans had to deliver against 5 nationally determined measures:-

-          Admissions into residential care

-          Effectiveness of reablement

-          Delayed transfers of care

-          Avoidable emergency admissions

-          Patient and Service user experience

plus 1 locally agreed measure which Rotherham had chosen as ‘emergency readmissions’.

The first draft of the plan had been submitted to NHS England on 14^th February, 2014.  It was reviewed by NHS England and also by a local authority peer review.  Initial feedback was:-

·           NHS England suggested that all the information was contained within the plan but needed much more detail before the 4^th April submission.  Based on what they had seen, it was likely to score “green”

·           The Peer Review stated that the plan showed really good evidence and agreed that it was a workable plan.  It also referred to engagement with the public and providers, impact on providers, development of actions, degree of transformational change, alignment with Health and Wellbeing Strategy, scoping of projects, finances and transfer of funds from Hospital/Acute Services to Community, Prevention and Early Intervention, performance targets and workforce requirements

Discussion ensued on the report and feedback with the following issues raised/clarified:-

-          Intention of the Fund to transfer money from Acute to Early Intervention and Prevention but was not new money.  However, this was complicated due to the two Government Departments (Health and Communities and Local Government) having differing opinions with regard to the Guidance, with the DoH view being recommissioning of NHS services and the CLG referring to whole system transformation.

-          Initial submissions had been assessed against criteria that had not been published at the time they had been submitted

-          The Officer and Task Groups were meeting on a regular basis where difficult negotiations were taking place which were not helped by the conflicting Government Guidance

-          Performance measures still had to be resolved with the Council’s representatives striving to ensure they met the 3 aims i.e. drive change, satisfy NHS England and be stretching but achievable.  Clarity was also required with regard to some of the re-commissioned projects as to the potential consequences for the Local Authority relating to funding

-          The funding would be paid in 2 or 3 tranches; the first 50% being drawn in April, 2014 and then evidence of performance and transformational change to enable drawing down of the remaining 50%.  If not, potentially the money could be withheld by NHS England and a damaged reputation

-          There had to be a whole system transformation so the plan needed  more emphasis on early intervention and prevention

-          The important role of unpaid carers in providing support and contributing towards prevention and early intervention as noted in the recent scrutiny review

Resolved:- (1)  That the work undertaken to develop a local Better Care Fund plan be noted.

(2) The Health Select Commission notes with concern the issues regarding the outstanding matters relating to the Better Care Fund submission. 

(3)  The Health Select Commission wants to be satisfied that the projects submitted have taken account of the effects on the whole system, so that citizen experience was improved end to end.   

(4) The Health Select Commission would also like assurance that all aspects of the plan were deliverable and that there were no unfunded consequences for the Local Authority.

(5)  That the final Better Care Fund be submitted to this Commission in due course.