Agenda item

This report is to provide an update on:

·        the national BCF reporting process

·        2020-21 Performance return for sign off

·        the planning arrangements for 2022-23

·         review of BCF Performance and Delivery Group Terms of Reference.

The Board received an update on the Better Care Fund (BCF), including the national BCF reporting process, 2020-21 Performance return for sign off, the planning arrangements for 2022-23 and a review of BCF Performance and Delivery Group Terms of Reference. The Director of Prevention and Commissioning was in attendance to present the report and respond to questions.

Key points raised during the presentation of the report included:

·        A BCF Framework was received in September which included changes to expectations of reporting and activity.

·        It was not nationally required to report on delayed transfers of care in 2021 or 2022, however officers stated that local delayed transfers of care were monitored.

·        Non-elective admissions fell in 2021, but this was primarily due to Covid-19.

·        The target of 85% of people staying at home post-90 days following hospital discharge had not been met, with around 79% of those discharged remaining at home.

·        Targets for admissions of older people into residential care homes, with admissions reduced in 2021.

·        A Better Care Fund Review had been carried out, which had identified the need to develop an intermediate and reablement care end-to-end approach. This had been set up as a rolling yearly programme of review to examine all BCF schemes each year.

·        There had been some changes to future planning arrangements, including changes to the method of reporting around non-elective admission which will focus on ambulatory care conditions. Also, on delayed transfers of care there was to be a greater emphasis on the length of stay.

·        The terms of reference of the BCF were still being reviewed, and there had been conversations within the BCF Delivery and Performance Group to make some changes to the terms of reference and membership, which was to be presented to the Health and Wellbeing Board in the next quarterly update.

Board members commented that:

·        It was important to ensure that local area co-ordinators are accountable to their ward and councillors in order to prevent a democratic deficit. Officers commented that:

-      Local area co-ordinators were run through the BCF which tracked and examined its progress e.g. in reducing numbers of people accessing social care by helping them to live independently. The Communities Recovery Board was also to have oversight of all work that ran through contracted commissions within the community and voluntary sector, including local area co-ordinators.

-      Recent reports from local area co-ordination had shown the system was working well to support those with complex needs to prevent the need for them to access health and social care, which was why an additional 4 local area co-ordinators had been recruited. These reports were to be shared with board members.

-      Local area co-ordinators did not work in isolation, and co-ordinated closely with primary care e.g. for social prescribing.

·        Performance information for the BCF had shown an continued year on year improvement on the number of people being supported to remain at home rather than having to access health and social care in a hospital, which was above the regional and national average. A focus on prevention of admission and reablement was to occur going forward with an expansion of these services with an aim to focus more on prevention.

·        It was retrospective to approve a financial plan in November, two thirds of the way through the financial year.

·        The BCF was to be rolled forward for another year and there was likely to be little material change between now and next year while the wider context around the place of the BCF in health/social care continues to be resolved.

·        All BCF schemes were reviewed in the summer of 2021 by the BCF Performance and Delivery Group, however it was agreed that there was room for improvement going forward, especially in supporting early intervention and prevention of readmission. There was some duplication of work in schemes, which was to be addressed by upcoming work around reablement and intermediate care.

·        In the next plan, it was likely there would be a reduced, consolidated number of schemes.

·        In hospitals, capacity had been constrained by the Covid-19 pandemic, with around 80 Covid-19 positive patients in hospital across York and Scarborough.

·        There had been support from City of York Council to facilitate discharges from Foss Park Hospital, particularly in the working age adult population, though there was a particular challenge in supporting older people e.g. with dementia and challenging needs.

Resolved:

i.             That the York better Care Fund update for information be received.

ii.            That the 2021/2022 BCF return be agreed.

iii.          That authority be delegated for future returns to be signed off by the Director of Prevention and Commissioning appropriate CCG lead in partnership with the Health and Wellbeing Board Chair.

Reason: The Health and Wellbeing Board is the accountable body for the Better Care Fund.