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Health and Wellbeing Board
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18 January 2023
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Report of:
Jamaila Hussain Corporate Director of Adults and
Integration
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£500m Adult Social Care Discharge Funds
Update:
Summary
1.
This paper provides the Health and
Wellbeing Board with an update on the allocation of the Adult
Social Care discharge funds. The Better Care Delivery Group has led
on this to ensure that all partners across the system have been
involved in putting forward schemes that focus on discharge and
flow.
2.
The application of funds is ring
fenced to schemes that focus on discharge only rather than
admission avoidance and the BCF Delivery Group convened a number of
extraordinary meetings to ensure a single agreed approach using
current data and performance metrics.
3.
This item was received late due
to
Background
4.
Earlier in 2022 additional
£500m funds by the Government were made available in
recognition the pressure all councils were facing within Adult
Social Care in terms of financial sustainability, workforce
sustainability, market sustainability and social care reform
implementation. Alongside this the additional introduction of a CQC
assurance process commencing in April 2023.
5.
There has been a delay in monies
being allocated whilst further national discussions were held
regarding to the administration of the funds and further health
negotiations.
6.
This resulted in a change in the
initial allocation to council and a shift in the administered and
split the funds at ICS and Council level. 60% of the funding has
been made available to the ICS and 40% directly to Councils, the
table below shows the funds available on a place footprint.
However, the fund requirement is still to support adult social care
to discharge patients out of hospital alongside health, voluntary
and community partners.
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ICS York Place
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£1,006,902
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City of York Council
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£609,834
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Main/Key Issues to be Considered
7.
The criteria set for the use of the
fund is quite descriptive and focusses primarily on the supporting
discharges out of the Acute Hospital Trust. The criteria sets out a
BCF approach that recognises the support of a wider system to
ensure that people are discharged from hospital in a timely
way.
8.
Several workshops have been held by
NHSE/I and the BCF National Team to ensure systems understand the
use of the monies and specific support to adult social care is
embedded as part of the delivery of the fund.
9.
The BCF Deliver Group has met
several times and agreed a BCF system plan that will support
discharge of patients out of hospital into the most appropriate
care setting.
10.
Although the Adult Social Care
Discharge Fund constrained the use of the fund only to use for
discharge. The BCF Delivery Group are committed to supporting the
Health and Wellbeing Board Strategy (HWBB) as well as meeting the
HICM set out in the BCF plan 22/23, and this is clearly reflected
in the plan outlined in the table below.
11.
A home first week also took place
mind November this week enable a specific focus on what challenges
are there within the trust and with partners to delays in discharge
and patients returning home. The Adult Social Care Discharge
Schemes put forward are also in conjunction with the learning from
this week led by Anita Griffiths, social care leads, housing and
health.
12.
The attached return in Appendix 1
highlights a list of schemes in place.
Schemes
13.
Community In-reach Discharge Team.
This is a multi-disciplinary team complete with therapy, social
work, mental health, and liaison services. This service will
in-reach in the hospital to expediate discharges. Data shows that
most patients on pathways one and two take between 5/8 days to
discharge and for some of the time in hospital can considerably
increase if this window is not achieved. The in-reach team will
look to reducing the discharge time to between 1-5 days depending
on complexity. To ensure this scheme is successful the delivery
group have underpinned this with several care and support schemes
identified within table above.
14.
Extension of additional 400 hrs of
Rapid Response Home Care. This scheme is currently in place and is
working well supporting the ‘early discharge of
patients’ home within 24 hrs of referral.
15.
Voluntary Sector Supported
Discharge. This scheme will provide additional transport, pop in
visits and safe at home arrival, this ensures homes are warm,
shopping completed, and the person is settled in once
discharged.
16.
Local Area Co-ordination to be part
of the MDT in-reach team, this will support early discharge home
with community oversight.
17.
Community Response Team additional
care at home support complimenting rapid response but support
individuals with higher care needs of 4 plus double call a day.
Initially supporting 4 patients on a rolling basis 22/23 moving to
8 in 23/24. This service will link closely with reablement,
brokerage and rapid response ensuring flow.
18.
Additional OT support into
reablement to support flow in the provision this has been a tested
model and alongside the commissioner have significantly reduced
reablement waits from 53 to 3.
19.
Time to Think Beds, there are
several patients who require further assessment however are
self-funders, these beds will allow patients the opportunity to be
assessed and allow long-term decision-making time.
20.
Step Down Beds, additional 7 beds to
support further step down and assessment to ensure longer term
decisions are made in a timely way.
21.
TEWV: Awaiting further
information
22.
Additional support to alcohol
services to support early discharge and reduce LoS for people with
complex needs.
All schemes outline a targeted approach to
discharges. The MDT will support earlier in-reach ensuring patients
who are ready for discharge are moved out of an acute setting as
quickly as possible and additional provision will ensure flow and
patients are supported with the right care at the right place. So
schemes are likely to change as further guidance is
released.
Options
23.
The Health and Wellbeing Board are
asked to note the report. Agreement of schemes have been reached
outside of the board due to timescales and 16th December
deadline for submission. All partners engaged with the BCF Delivery
Group have had an opportunity to be engaged in the
process.
24.
The DASS and S151 Officer have
delegated HWBB authority to sign off the schemes before the next
HWBB.
Governance
25.
There are two national templates
that will have to be completed and returned to BCF National Team
and NHSE/I fortunately, additional funds have been made available
for administration. Updates will be provided to partners at the
regular system meeting held every Friday as well as the York Health
and Care Partnership and HWBB
Strategic/Operational Plans
26.
The List of schemes can be found in
section 1. The schemes outlined for the purpose of the report are
highlighted in white. The other schemes provide an outline of other
initiatives supporting discharge and admission
avoidance.
Implications
27.
This report is an update on previous
BCF report and there are no significant
implications.
28.
Financial
Further discussion are being held with North Yorkshire to ensure
that previous schemes funded at risk are appropriately costed and
attributable to each organisation. For example, the Overdene beds
are only utilised as an 80/20 split and therefore the York place
contribution will be on a proportionate basis.
·
Human Resources
(HR)
N/A
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Equalities
The BCF Plan ensure equally access
to all individual meeting the criteria.
·
Legal
N/A
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Crime and Disorder
N/A
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Information Technology
(IT)
Work to commence to ensure capture
of discharge information is correct
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Property
N/A
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Other
N/A
Risk Management
29.
The situation is quite challenging,
and all schemes will be monitored weekly to ensure flow out of the
acute setting.
Recommendations
The Health and Wellbeing
Board are asked to:
i.
Ratify the
allocation of the Adult Social Care discharge funds
ii.
Note the contents
of the report
iii.
Note that updates
will be provided to the partnership monthly
Reason: To keep the Board
updated on the allocation of the Adult Social Care discharge
funds.
Contact
Details
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Author:
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Chief Officer Responsible for the
report:
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Jamaila
Hussain
Corporate
Director of Adults Social Services and Integration
City of York
Council
jamaila.hussain@york.gov.uk
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Jamaila
Hussain
Corporate
Director of Adults Social Services and Integration
City of York
Council
jamaila.hussain@york.gov.uk
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Report Approved
Date 15/01/23
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Date
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05.01.2023
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Wards Affected:
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All
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P
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For further information please contact the
author of the report
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Appendixes:
Appendix A -
Adult Social Care Discharge Fund 2022-23 First Activity Reporting
Template
Glossary
HWBB: Health and Wellbeing
Board
BCF:
Better Care Fund
LoS:
Length of Stay
DASS
Director of Adult Social Services
