Agenda item

Richard Hills, Education, Care and Health Services, London Borough of Bromley, made a presentation to the Board. The slides for this presentation can be viewed under the following link: 

http://cds.bromley.gov.uk/ieListDocuments.aspx?CId=617&MId=4636&Ver=4

He explained The Spending Round 2013 announced a pooled budget of £3.8 billion for local health and care systems in 2015/16.  Referred to as the “Integration Transformation Fund” (ITF).

The fund was designed to support an increase in the scale and pace of integration and also be a mechanism for promoting joint planning for the sustainability of local health and care economies against a background of significant savings targets right across the system.

Although announced as if this would be new money into the health and care system the fund was mainly created through top slicing existing budgets. Top slicing Clinical Commissioning Group (CCG) budgets made up over 65% of the fund, the rest was from top slicing the Local Authority budget and adding the existing Department of Health (DoH) Social Care Grant which was now subsumed into ITF.

The fund could not be accessed individually it had to a joint application from the LA and CCG through their relevant Executives, it would then go to the HWB and finally to NHS England.  Additionally access to the fund would be dependant on agreement of a 2 year plan for 2014/15 and 2015/16.The plan needed to be submitted to NHS England by February 2014. There were measures that still needed to be determined; Delayed transfers of care, Emergency admissions, Effectiveness of reablement, Admissions to residential & nursing care and Patient & service user experience and £4m of the fund would be performance related, but this should not be problematic as Bromley’s integration was already ahead when compared to other authorities. 

The new fund would be simpler to budget and account for and any under spend could be easily identified.  In addition the Board would have a clear oversight of the fund.

Members of the board raised concerns about sharing data using National Insurance Numbers.  It was explained that the Government had not been prescriptive about how data was collected.  Paul White, ProMISE Programme Director would be looking at how best to streamline this process,

In terms of accessing the system it was likely that when users logged on to look at a resident’s record through the “Carefirst” Portal they would be advised that there was also a record on that resident under the RIO Portal and users would need to access both systems.

In response to a question about the involvement o the London Ambulance Service (LAS), pharmacies the Director explained that the Pharmaceutical needs assessment formed part of the integrated services.  However it was not intended, at this point, to include the LAS.

In relation to targets the Director explained that one of these was Accident and Emergency admissions and this would need the involvement of the PRUH as there was a collective responsibility to improve the targets.  There was a strong incentive for the Board to ensure the PRUH delivered.

RESOLVED that:

1. The report is noted.
2. A joint working party be convened for both the LA and CCG to meet throughout December in order that a draft plan can be presented back to the Board in January 2014.
3. It be confirmed that the Board recognises that ITF is the model for government funding of the health and care economy in the future.