Health and Wellbeing Board	January 6^th 2021
Report of the Assistant Director – Joint Commissioning, City of York Council and Vale of York Clinical Commissioning Group

Better Care Fund Update

Summary

1. This report is to provide a brief update on the arrangements for the Better Care Fund 2020-21 and 2021-22.

Background

2. The background information on the BCF has been previously reported to the Health and Wellbeing Board (HWBB), with quarterly updates now the normal routine.

3. As outlined in the previous report to the Health and Wellbeing Board, the planning requirements for 2020-21 were anticipated during October 2020. 

4. The government published a short statement about the Better Care Fund on 3^rd December 2020.  This can be accessed here:

https://www.gov.uk/government/publications/better-care-fund-policy-statement-2020-to-2021/better-care-fund-policy-statement-2020-to-2021

Earlier in the year, Health and Wellbeing Boards were advised that BCF policy and planning requirements would not be published during the initial response to the COVID-19 pandemic and that they should prioritise continuity of provision, social care capacity and system resilience and spend from ring-fenced BCF pots based on local agreement in 2020 to 2021, pending further guidance. Given the ongoing pressures on systems, Departments and NHS England and NHS Improvement have agreed that formal BCF plans will not have to be submitted to NHS England and NHS Improvement for approval in 2020 to 2021.

5. The national conditions for the BCF in 2020-21 are that:

· Plans covering all mandatory funding contributions have been agreed by HWB areas and minimum contributions are pooled in a section 75 agreement (an agreement made under section 75 of the NHS Act 2006).

· The contribution to social care from the CCG via the BCF is agreed and meets or exceeds the minimum expectation.

· Spend on CCG commissioned out of hospital services meets or exceeds the minimum ringfence.

· CCGs and local authorities confirm compliance with the above conditions to their Health and Wellbeing Boards.

6. York BCF is compliant with these conditions.  The roll forward plan for 2020-21 has been previously reported to the board.  The financial summary of the plan is attached at Annex 1 for HWBB.

Main/Key Issues to be Considered

7. The Spending Review 2020 confirmed that the iBCF grant will continue in 2021 to 2022 and be maintained at its current level. The Disabled Facilities Grant will also continue and will be worth £573 million nationally in 2021 to 2022.

8. The CCG contribution will again increase by 5.3% in line with the NHS Long Term Plan settlement.

9. The Policy Framework and Planning Requirements will be published in early 2021.

10. As previously highlighted, the use of single year agreements by the Department of Health and Social Care (DHSC) has created an undesirable level of insecurity for service providers funded through BCF, included for individual staff members across our system where posts are subject to fixed term contracts. The experience of receiving the policy and planning requirements mid-way through the year compounds this, and has made it difficult to refresh or significantly revise plans from one year to the next in recent years.

11. The multi-agency BCF Performance and Delivery Group has developed plans in partnership with service providers to support system resilience over the winter period by investing in out of hospital services, support for carers and other preventative measures for the current year.

Consultation

12. The BCF Plan 2020-21 was developed in a collaborative process with partners, and is co-produced with the scheme providers. 

13. The financial assumptions for a roll forward into 2021-22 are being reviewed to ensure BCF is delivering the greatest impact on outcomes possible.  This process is ongoing and means future commitments will be confirmed at a later date.

Options      

14. The HWBB will receive further reports on future commitments.   

Analysis

15. n/a

Strategic/Operational Plans

16. The Joint Health and Wellbeing Strategy is the overarching strategic vision for York; this plan supports the delivery of the desired outcomes.

17. The York BCF Plan 2017-19 provided the foundation for the BCF Plan 2019-20 and 2020-21.  It has evolved each year in line with refreshed intelligence and national directives.

18. This work is congruent with the Council Plan and the NHS Long Term Plan.

19. BCF schemes have been central to the COVID-19 pandemic response, including the implementation of the Hospital Discharge Policy.

        Implications

· Financial – BCF is a pooled fund through a Section 75 Agreement between NHS Vale of York CCG and City of York Council.

· Human Resources (HR) – many of the schemes funded through BCF are supported by staff on fixed term contracts.  The prevalence of short-term funding and fixed term employment contracts are a significant risk to the stability and continuity of our system.

· Equalities - none

· Legal - none

· Crime and Disorder  - none

· Information Technology (IT) – information technology and digital integration forms part of the system wide improvement plan, relevant representatives from statutory agencies attend the project board, and there are plans to engage non-statutory services and the patients, customers and families in our developments.  The national and regional work on this agenda guides our local work.

· Property - none

· Other – none.

Risk Management

20. Governance processes are in place between the partners to manage the strategic risks of the BCF as part of our whole system working.

        Recommendations

21. The Health and Wellbeing Board are asked to:

i. Receive the York Better Care Fund update for information.

Reason: 

The HWBB is the accountable body for the Better Care Fund.

ii. Delegate responsibility for signing off the BCF Plan 2020-21 to the Chair and Vice Chair, supported by the council Corporate Director of People and the CCG Accountable Officer.

Reason:

The government has now confirmed that the plan will not need to be submitted formally as in previous years.  The plan commitments are recorded within the NHSE excel template.  This can be obtained from the report author on request but is not in an accessible format for publication.  A financial summary is attached at Annex 1.

iii. Note the intention to review the financial allocations for BCF 2021-22 to ensure maximum impact on outcomes for the system.

Reason:

It is important for the sustainability and stability of the whole system that the funding commitment is reviewed regularly to be assured of value for money and impact on outcomes.  The Chair and Vice Chair, have approved this approach, supported by the council Corporate Director of People and the CCG Accountable Officer.

Contact Details

Author:	Chief Officer Responsible for the report:
Pippa Corner Assistant Director – Joint Commissioning People Directorate City of York Council & NHS Vale of York CCG 07500973261	Amanda Hatton Corporate Director - People City of York Council Phil Mettam Accountable Officer NHS Vale of York CCG
	Report Approved	✔	Date	17.12.2020
Wards Affected:					All	x
For further information please contact the author of the report

Background Papers:

Better Care Fund 2019-10 Policy Framework

Better Care Fund 2019-20 Planning Requirements

Better Care Fund 2020-21 Planning template

Annexes

Annex 1 – summary financial plan BCF 2020-21

Glossary

BCF – Better Care Fund

CCG – Clinical Commissioning Group

CYC – City of York Council

DHSC - Department of Health and Social Care

HWBB – Health and Wellbeing Board

IT – Information Technology

NHS - National Health Service

NHSE&I - NHS England & Improvement