Agenda item

The paper is to provide an update on the Better Care Fund Plan for 2024/25 for information. The purpose of the paper is to assure the Board that robust planning and monitoring processes are in place. 

Contact: Vicky Dutchburn, Director Of Operational Delivery & Performance (Kirklees), West Yorkshire ICB, Cath Simms, Service Director, Adults Social Care Operation, Tel: 01484 221000.

Cath Simms, Service Director, Adults and Social Care Operations and

Vicky Dutchburn, Director of Operational Delivery and Performance, provided the Board with an update on the Better Care Fund (BCF). The aim of the update would be to outline the plan spend through the BCF for the 2024/25 financial year, and also the plan for next year, and to get agreement from the Board. 

The Board was provided with an overview of the BCF, which is a mechanism for joint spending between the ICB, health and the council.  It is not new money it is direct from the council and the ICB.  The only exception to that is there has been some additional three year national non-recurrent funding specifically for adult social care, supporting hospital around discharge. The final year for the funding is 2024/25 and it is not clear whether there will be a repeat of that funding, although there may be some additional monies coming through for that.

There are some very clear national conditions and requirements that have to be followed in order to spend this money.  Essentially it is around enabling people to stay well, safe and independent at home for longer providing the right care, in the right place, at the right time.  There is a clear planning framework that needs to be followed.  The recent one was a two year planning framework, the BCF plan covered from last year 2023/24, through to this year 2024/25. 

The Board was provided with a summary of how both partners, the ICB and the Council contribute to the pooled funding as follows:

 Source                                 £ ICB                    £ Kirklees Council

The Board was informed that in terms of how the spending has been planned for this year, a working group was established with representation from the ICB and Kirklees Council to oversee the planning process. For the 2024/25 plan, each scheme has been subject to a review to determine:

Review criteria

-        Delivery against national objectives

-        Risk to future delivery

-        Value for money

-        Opportunities for efficiency through transformation

Update and approvals

-        In terms of approvals, the Health and Wellbeing Board (H&WB) is required to complete a planning template and delegated authority for this has been given to Vicky Dutchburn and Cath Simms to submit on behalf of the H&WB. Updates have also been delivered to the Joint Kirklees Senior Leadership Team. 

-        The plans were submitted to the BCF team in August, and the Section 75 agreements is being updated.  This is a legal agreement to outline how the money is to be spent

The Board was informed that there is often an element of back and forth with the national BCF team regarding whether the narrative about how the money is going to be spent is explained to them.

In terms of key points:

-         It is imperative that the plans meet the minimum financial contributions

-        Aligned with financial planning assumptions

-        Compliant with national conditions

-        Aim to maintain or improve on 2023/24 outturn for BCF metrics

One of the aims is to improve on performance for 2023/24, which is why there has been planning regarding what worked well and what didn’t.  The Board was provided with a summary of the seven key scheme which forms part of the BCF spend, as outlined in the appended report.

1       Aids to Daily Living

2       Transforming Intermediate Care and Reablement

3       Carers Support

4       Supporting Social Care

5       Supporting the Voluntary and Community Sector

6       Care Home Support

7       Discharge

The Board was informed that one of the learning points from undertaking the planning cycle for 2024/25, was that some of the timings did not align very well for example, the budget planning cycle started before the NHS planning cycle for budget, which started at a different time to the BCF planning cycle.  To address this, a new process has been set up, with the aim of starting the planning cycle earlier for next year with the intention of getting the indicative plans together by mid-October, to then feed into the Council and NHS Plans.

Each of the leads for the different schemes are asked to present, what has been achieved, how it has contributed to the core objectives, any challenges or pressures and if there are any opportunities to use the money differently.

The Board was informed that all the schemes are currently being reviewed, and the minimal level of investment will be maintained, regardless of what happens with the scheme.

Outcomes

-        Integrated Dashboards - joint activity and performance dashboards (EG integrated health and social care dashboard) provide a uniform system voice on flow, using historical data to understand variations throughout the year

-        Modelled Bed Capacity - evidence based data and insight support our modelled bed capacity in Kirklees and there is confidence in the planned bed capacity and bed mix, with arrangements in place to handle system pressure. Shortfalls in community capacity will be met through spot purchase arrangements

-        Demand Shift - anticipated ‘left shift’ in demand from P2/P3 volumes to P1 ensures more people receive the right level of support to get them home. Admission avoidance services likeUCR will continue to support the system

-        Home First Strategy – the system wide Home Strategy and Plan aims to divert investment from bed-based solutions to home based offers, enhancing services like Reablement Therapy, consolidating bed-based offers, and supporting hospital transfers

-        Dedicated Resources –1)  IMC bed base with dedicated nursing and therapy resources to maximise independence 2) Recovery Bed Base with a dedicated therapy team for intense in-reach therapy

In response to the information presented, the Board asked a number of questions and made comment including some of the following:

-        Do Community Champions and Community Anchors play a part in this.  Social prescribing has been around for a while and has a strong role and there are innovative things happening through the VCSE in Kirklees and it would be good to see how that might be helping to contribute to this.

-        When there is a better picture of what is coming in the years ahead, when there may not be defined funding, when would be a good time to come back to the Board and provide an update on how the landscape may have changed?

RESOLVED

That Cath Simms and Vicky Dutchburn be thanked for providing an update on the Better Care Fund.