Agenda and minutes

Apologies were received from Councillor Tim Stevens.

Report CS14094

Following a review of all Better Care Fund (BCF) plans nationally, NHS England advised local authorities and Clinical Commissioning Groups (CCGs) on 25^th July 2014 that key policy changes to the BCF required plans to be revised and resubmitted by 19^th September 2014. Accordingly, agreement was sought to a revised BCF financial submission.

The Executive Director introduced the item outlining key drivers behind the need for Local Authorities to provide a further submission. These included a need to demonstrate increased performance in reducing unplanned admissions, with more community based schemes enabling residents to stay in their homes longer.

More evidence of provider engagement and agreement on the impact of plans was also necessary along with greater clarity around the alignment of the BCF plan to wider plans and policies. More evidence was also needed of robust finance and activity analytical modelling to underpin plans. The Government also felt there was a very high risk that the sums identified for transfer from the NHS to local government may not be achievable.

Although Report CS14094 referred to a new 3.5% reduction target in unplanned admissions (with about £2m held back in Bromley’s case if acute savings were not achieved on integrated care for older people), it had been possible to reduce the target to 2.75% in the final submission following agreement with NHS partners. This reduced the risk for L B Bromley as this was linked very clearly to the admissions avoidance programme which was already fully funded (PROmise). 

Report CS14094 outlined proposed 2015/16 spend as detailed in the BCF submission. Certain existing grants to be subsumed into the BCF remained unchanged and were still protected. Funding to protect social care and underwrite pressures from the Care Act (not at risk under the performance arrangements) had increased to £3.5m (formerly £3m in the original submission). Costs of the Care Act for L B Bromley in 2015/16 were assumed by the Department of Health to be £750k.Local authorities could use the social care protection funding and grant funding for existing schemes to contribute to any further costs arising from the Care Act.

Further schemes totalling £7m were being drawn up by LBB and CCG officers to meet BCF requirements, national ambitions of the Care Act and local ambitions to drive down cost through demand management. This relied in part on a strong community and short term intervention model e.g. information, advice and guidance, carers support, and a step up medical response service.  There was a significant sum within the £7m for Community Equipment which was dealt with by the S.75 Agreement. The £2m at risk as a result of the new performance framework had been set against extension of the existing integrated care programme for older people. This was essentially payment by results (PBR) and following negotiation with the CCG, the PBR element would be held at the CCG’s risk – it was therefore fully funded by the CCG.

The final submission, previously  ...  view the full minutes text for item 72.