Agenda item

The Better Care Fund—Local Plan 2017-19 report was written by Jackie Goad (LBB Executive Assistant), and the update was provided jointly by Dr Angela Bhan (CCG Chief Officer) and Ade Adetosoye (LBB Deputy Chief Executive and Executive Director of Education, Care and Health Services). The Board heard that the BCF draft Local Plan was based on three key principles:

·  Working within the allocated budget

·  Achieving effective integration between health and social care

·  Improving outcomes for patients

The Board were briefed on the four national conditions that Bromley was required to meet:

  I.  The BCF Plan had to be jointly agreed by the CCG and LBB, and signed off by the HWB

  II.  The NHS contribution to social care had to be linked to inflation

  III.  There had to be an agreement to invest in NHS commissioned out of hospital services

  IV.  The ‘High Impact Change Model’ for managing Transfer of Care had to be implemented

It was noted that the submission date for the BCF Local Plan was September 11th 2017.

The Plan had to strategize to minimise delayed transfers of care, and to establish base-line targets. The draft plan may require adjusting.

The HWB agreed to delegate authority to Dr Bhan and the Deputy Chief Executive to make the final adjustments to the draft--so that the submission of the final plan would be ready for Monday, September 11^th.

Dr Bhan stressed the importance of getting patients out of hospital as soon as possible, and was grateful to the Deputy Chief Executive for his work around facilitating hospital discharges. She mentioned that if an 80 year old was in hospital for seven days, that person would lose 15% of muscle mass.  Dr Bhan stressed the importance of getting schemes working as soon as possible to meet DTOC ambitions, as the targets were challenging. 

Dr Bhan felt that the ICN’s and Dementia Hubs were working well, and thanked the Board for their ongoing support in these areas. 

The Chairman remarked that the report was good, and that pace was now required.

Councillor Judith Ellis referred to section 5.51 of the report which referenced the joint funding protocols being developed by LBB and the CCG. She expressed the view that the proposals were not moving forward quickly enough. Dr Bhan agreed that more progress was required around the development of personal health budgets.

It was noted that a new appointment of Discharge Commissioner had been made, and this person would be provided with collateral support from Dr Bhan and the Deputy Chief Executive.

Councillor Dunn referred to table 2 in section 7.2 of the report. This table showed various schemes with the associated budgets for 2017/18 and 2018/19. He pointed out that for each scheme, there had been allocated a 2% increase in funding for the following year across the board. He queried if this was a mis-allocation. Dr Bhan clarified that the 2% figure was used for budgeting purposes, and was just a starting point.

The Deputy Chief Executive stated that in order for the correct pace to be maintained, it was important that joint meetings took place with joint leadership appointments. It was key that capacity be improved, along with take-up of the increased capacity.

Dr Bhan informed the Board that many ‘Red Bags’ had been distributed to Care Homes and Hospitals during May and June. These would contain items that would be useful for the patients during their stay in hospital—things like hearing aids, glasses, false teeth. The plan was that alongside the red bag, health information ‘passports’ would also travel with the patient into hospital.

Councillor Robert Evans was not convinced that full integration could take place by the 2020 target. By way of illustration he referred to the diagram on page 55 of the report (section 5:16) which depicted the current ICN (Integrated Care Network) governance structure. He highlighted that LBB was not currently incorporated into the governance structure. He also asked if in the last year there had been an underspend for ICNs.

The Deputy Chief Executive responded that there was an expectation that the CCG would deliver on the targets that had been set by local government. Concerning the issue of LBB being involved in ICN governance, a report would be going to the Executive in October to look at LBB’s role in the governance of ICNs. It was expected that LBB would play the maximum role possible. The Deputy Chief Executive confirmed that there had been an underspend which had resulted from delays in the implementation of some of the programmes and service provision. However, residents would still benefit and the underspend could be re-allocated to assist with dealing with winter pressures.

Councillor Cooke commented that she felt that cooperation between LBB and the CCG was better than ever before, and for the first time she was optimistic for positive outcomes this winter.

RESOLVED that (subject to final adjustments as required by Dr Bhan and the Deputy Chief Executive) the HWB agree the BCF Local Plan, and consent to its submission to NHS England.