Agenda item

To discuss the allocations for 2015/2016 and agree priorities.

Written report by Joy Hollister.  Presented by Alan Steward and Barbara Nicholls.

Following the detailed guidance received at the Board meeting in December 2013, the draft submission for the Better Care Fund Programme (formerly the Integration Transformation Fund) was presented to Board members. The report outlined the joint view of the Clinical Commissioning Group (CCG) and the Local Authority in their approach for greater integration in care delivery and commissioning. The draft submission was due to be forwarded to NHS England by 14 February 2014 and that a final version would be formally submitted on April 4 2014, therefore, committed judgements on performance, financial commitments and outcomes needed to be clear by that date. A condition of accessing the funding is that there must be joint spending plans and that these plans must meet certain requirements.

The Better Care Fund (BCF) had three key objectives:

·                     Ensuring more joined up and effective commissioning including procurement, specification and contracting of NHS and ASC services

·                     Delivering more integrated solutions for citizens /service users and patients at the most appropriate and local level possible

·                     Ensuring improved management of the use of high cost resources through targeted and GP centric and locality interventions , so avoiding hospital and long term care home admissions

Members were advised that a formal pooled fund, totalling circa £16.884m would be created from April 2015. This would combine Section 256 allocations into a single resource together with the Disabled Facilities grant and Adult Social Care capital grant.  During the course of 2014-15 an allocation of these monies would be utilised by Havering in meeting the key objectives together with, in part, the protection of Adult Social Care and related expenditure for implementation of the Care Bill. 

It was noted that Havering’s allocation using the social care relative needs formula (RNF) is expected to be £4.609m, of which £838k is related to the additional funding. The funding in 2014/15 would be subject to the same conditions attached to the existing transfer.

It was agreed that the Authority and CCG were building on excellent foundations and that the establishment of the Integrated Care Coalition (ICC) had formed a good basis from which to drive the project forward. 

The BCF is associated with a number of national performance indicators and targets which would require sign off at a national level against local benchmarking and self-identified ambition. The performance targets are:

·                     Reducing admissions to long term care homes

·                     Effectiveness of reablement

·                     Delayed transfers of care

·                     Avoidable emergency admissions

·                     Patient and service user experience;

In addition, one measure would be determined locally, and it was recommended that it be associated with carers so as to complement the emphasis in the Care Bill for a renewed focus on this area of policy. It was noted that the aim was keep people away from hospital, in particular, those with learning difficulties or dementia and to provide more care in their own homes.

The Board agreed that further voluntary and community input would be required and that community groups should be approached. Members were advised that Futuregov had opened the Public Sector Launchpad to bring innovation into local public services and that two members of the Board planned to investigate further.

The Board were asked to note the five year projection plan and the initial two year period of priorities and actions to implement in 2014/2015.  Work would continue in developing the document leading up to final submission by April 4^th 2014. Members of the Board were asked to forward any comments regarding the submission onto officers prior to that date.

A proportion of the BCF is payable on the achievement of the agreed performance targets with performance in the main, against 14/15 measurement.

            It was noted that in the spending round indicated that £1bn of the £3.8bn would be linked to achieving outcomes, both national and local. Half of the funding is expected to be released in April 2015. £250m of this would depend on progress against four national conditions, and £250m would relate to performance against a number of national and locally determined metrics during 2014/15. The remainder (£500m) would be released in October 2015, and will relate to further progress against the national and locally determined metrics.

At a local level, the Health and Wellbeing Board will provide the oversight for the application of the wider change agenda, the local application and interpretation of the wider strategic requirements, together with driving forward both the integrated Health and Wellbeing Strategy and the Joint Commissioning intentions of the emerging Havering CCG and Local Authority. It will hold the commissioners in Havering accountable for both the financial and performance metrics outlined in the submission.

It was noted that from April 2015, the pooled fund will be governed by the Section 75 agreement.

The Board agreed to:

·                     Approve the draft Better Care Fund bid for submission to NHS England

·                     Authorise the Chairman to sign the draft submission to NHS England

·                     To receive, prior to April 4, the final submission in respect of the Better Care Fund.