Agenda item

Better Care Fund and Improved Better Care Fund


Report ECHS19037


The Board considered a report which provided an overview of the performance of both the Better Care Fund (BCF) and the Improved Better Care Fund (iBCF) 2018/19. The report provided both expenditure and activity for the third and fourth quarter period, between October 2018 and up to the end of March 2019.


For the BCF, Bromley was responding to four national metrics: the reduction in non-elective admissions; delayed transfers of care (DToC); the rate of permanent admissions to residential care per 100,000 population; and the proportion of older people (65 and over) who were still at home 91 days after discharge from hospital into reablement / rehabilitation services. The Interim Director of Programmes advised Board Members that there had been an overall reduction in the number of non-elective admissions, and the targets set had been met. In relation to DToC’s, Bromley were now rated number one compared to the other 32 London Boroughs, and admissions to residential care and reablement had both exceeded the targets set. The Bromley Well service, one of the BCF schemes, had provided a Single Point of Access for local people to prevent them from falling into a crisis and improve their health, wellbeing and independence, and in every area all the targets were being met.


The iBCF schemes reflected three grant conditions, that the fund be used only for the purposes of: meeting Adult Social Care needs; reducing pressures on the NHS, including supporting more people to be discharged from hospital when the were ready; and ensuring that the local social care providers market was supported. One scheme was the Assessed and Supported Year in Employment (AYSE) Lead and Placements Coordinator, in which the AYSE Lead supported newly qualified Social Workers and aimed to keep them with the Local Authority.


A Board Member noted that section 4.49 (Support to the Sector) in the commentary of the report appeared to finish mid-sentence. The Interim Director of Programmes apologised, and advised that the rest of the sentence would be included in the minutes of the meeting.


Following the meeting, the Head of Early Intervention, Prevention and Community Services Commissioning confirmed that the sentence should read:

4.49 In quarter 3 and quarter 4 the service has focused on Service Improvement Plan showing results across Associate Members and Volunteering. There has been an increasing volume of Training and Learning workshops from 3 in quarter 3 to 9 in quarter 4.


In response to a question, the Head of Early Intervention, Prevention and Community Services Commissioning advised that the Learning Disability Pathway outreach targets were below the requirement in Quarter 3. As a result, partners had worked together to make improvements, and those that were excelling provided support in the communities. Quarterly information was also provided and monitored.


In respect of Continuing Care and individual packages, a Board Member queried which partners paid for which elements of the packages, and if agreement on this was easily reached. The Managing Director: Bromley CCG reported that lots more work was being undertaken collaboratively, but noted that there was more that could be done. During the previous year, there had been approximately 35 relevant clients in this category, and 21 of the cases had resulted in a 50:50 split of the costs. For the remainder of the cases, the CCG had paid differing proportions of the costs. The Director: Adult Social Care stressed that it was essential for partners to work collaboratively to achieve the best outcome for an individual.


The Head of Early Intervention, Prevention and Community Services Commissioning confirmed that an agreement had been secured to pilot a Trusted Assessor process between Bromley and Croydon. This would allow a Social Worker in Croydon to decide if a patient could be discharged, and reduced the need for Social Workers to travel out of borough. This had reduced the length of stay for Bromley patients in out of borough hospitals, as they no longer needed to wait for a ward assessment.


A Board Member highlighted that in Quarter 4 there had been underspends of £750k (BCF) and £1.5m (iBCF), and queried why this funding had not been spent. The Director: Adult Social Care noted that in relation to the BCF budget, there was sometimes a time lag, but this would be looked at and a response provided to the Board. The Interim Director of Programmes informed Board Members that the £1.5m was linked to the Bromley care home, and had been set aside to facilitate the project if a positive recommendation was made. If not, the funding would be reallocated. In response to a question, the Interim Director of Programmes advised Board Members that a Business Case report on the development of a Bromley care home for adults was imminent, and would be discussed in detail following sign off from the Interim Chief Executive.


A Board Member asked if there were figures available in relation to the BCF Employment and Education scheme, regarding employment targets and employer engagement, and if there was further information on the collaboration with Bromley and Croydon’s Women’s Aid to develop a support group for women subject to domestic violence experiencing common mental health problems. The Head of Early Intervention, Prevention and Community Services Commissioning responded that this would be confirmed following the meeting.


The Independent Chair: Bromley Safeguarding Adults Board highlighted the work that had been undertaken with the South London and Maudsley (SLAM). It was an exemplary piece of work which had achieved its aim, and the team should be commended for the work that they had done.


RESOLVED that the performance and progress of the Better Care Fund and the Improved Better Care Fund schemes, as well as the financial performance for Quarters 3 and 4 2018/19 be noted.

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