Update from Group Director – Children, Adults and Housing.
Minutes:
It was explained that previous applications to the Better Care Fund had been withdrawn by Government at a national level. The ambition of the Fund was however unchanged.
Officers were now more assured that sufficient funding would be available for 2015/16. The 2016/17 year was however likely to be difficult and eligibility criteria etc was not yet known. It was emphasised that the Better Care Fund was not new money but was a reallocation of money from the NHS and social care.
The number of schemes in the Havering Better Care Fund action plan had been rationalised and a particular concern were the new responsibilities for support to carers that had been placed on the Council. The Health and Wellbeing Board would lead on this while a new Joint Commissioning Board would carry out the day to day work. This Board would be meeting in shadow form from October 2014, chaired jointly by Adult Social Care and CCG officers.
It was noted that BHRUT was felt to be a risk given hospital operational pressures and uncertainty over the Trust’s workforce to deliver the Better Care Fund work. The Chairman felt that the implications of the Dilnott report should also be mentioned as a risk. The implications of the Care Act were also not fully known at this stage.
Risk measurement had been undertaken in accordance with guidelines and risk levels were felt to be on the cusp for BHRUT and over the cusp on financial issues. It was felt the final version of the submission should state that the CCG needed support from the Trust Development Authority in order to mitigate the problems at BHRUT. The McKinsey work could also be quoted in the background section. It was felt it should also state that the Better Care Fund allocation in no way represented the population of Havering.
There was felt to be a bigger risk from the non-delivery of the Strategic Plan than posed by the Care Act. The total risk was approximately £300 million over the next five years and it also felt that the submission should make the point that NHS costs were not absolute, unlike those of Local Authorities.
The section on contingency planning and risk sharing needed further work although a workshop on this had been held on 27 August. A diagram would be inserted to show the balance of risk between the Council and the CCG. The risk between commissioners and providers would also need to be considered.
Information was given in the submission about the financial implications for the Council budget as well as comparative data with neighbouring Councils. Schemes to manage demand were also detailed. It was suggested that details of the large number of care homes in Havering be included as well as graphs showing the underfunding of the CCG and large numbers of elderly people in the borough. The final document was due to be submitted by 19 September.
It was noted that the Government performance target on admission avoidance of 3.5% may not be achievable.
It was agreed that sign-off of the final document be delegated to the Chairman and that it was unlikely that a further meeting of the Board would be needed to discuss amendments. The Board recorded their congratulations to the team who had worked on the template.