Better Care Fund (BCF) Update

City of York and the ICB collectively oversee £21.7m spend across Health and Social Care to support system flow, maintain independence, reduce hospital delays and admissions.

A BCF Delivery Group has been in place to make collective decisions around how we spend the money allocated within the BCF and what schemes have the greatest impact. This group has recently undergone a change in structure, to focus more on joint commissioning under a system lens, looking at the way all funding is utilised, including, but not limited to, the BCF. In conjunction with this, we also have a quarterly provider led meeting in addition to officer led joint commissioning forums.

We have recently completed a review of all the schemes with a view to determine which are delivering value for money, which are core with contractual obligations against them and which can be reviewed for potential re-focusing to ensure we are responding to the needs of the population and crucially, changing the way we deliver health and care to provide better experiences for patients and improved clinical outcomes.

The reviews have been successful and have enabled a new way of delivery through an Integrated Frailty Hub together with a single team working together including the CVS, Brokerage Social Workers, Intermediate Care, PCNs, CRT, TEVW and the Acute Trust.  The service went live 6 months ago and is now fully embedded into the intermediate care landscape. We are now looking to expand the reach of the service by including an in-reach model for pathway 1 patients.

As part of our commitment to Home First we are recommissioning our Reablement Services that will support all needs including Physical Disability, Learning Disability and Mental Health.  We are aiming to support a majority of people coming out of Hospital through Reablement Services and Intermediate Care, as this supports our ethos of Early Intervention. We are working with health colleagues to refine the specification for reablement services to ensure a truly integrated model.

The scope of this programme is extensive, reflecting the degree of transformation that is required if we want to make a shift in how health and care are delivered and funded to ensure we are designing fit for purpose, sustainable services that are both futureproof and flexible enough to adapt to shifting landscapes.

The BCF Project Manager works closely with finance and health colleagues and a monthly assurance is sent to the National BCF Team.  Most recently we have completed our Winter Plan including the additional social care winter monies. The bid, which was successful, comprised additional step-down beds, community support and domiciliary care as well as a contribution to the newly established York Frailty Hub which focuses on prevention and admission avoidance.

Next steps for the BCF Delivery Group is to have discussion around further growth and pooling of monies. As the Group comprises of all partners, decisions and are made collectively ensuring a whole system approach.