Agenda item

To consider the joint report of the Chief Operating Officer, Leeds South and East CCG and the Director of Adult Social Care, Leeds City Council, which presents the Board with The Leeds Better Care Fund Plan for 2016/17 (year two).  The BCF Delivery Group has used the learning from year one to create a Plan that will meet national conditions and support the wider ambitions of transformation that is being articulated in the Leeds Sustainability and Transformation Plan.

(Report attached)

Matt Ward, Chief Operating Officer, Leeds South and East CCG, presented a report as an introduction to the Better Care Fund (BCF) Submission, which required sign-off from the Health & Wellbeing Board prior to its final submission. It was noted that the date for submissions had changed since the publication of the agenda from 25^th April 2016 to 3rd May 2015. As this was the second operational year of the BCF; the report provided a comparison between 2015/16 and 2016/17 and noted that the general ambitions remained constant.

The report detailed how, although the BCF allocation for 2016/17 was £1 million more than last year (a total of £55.9 million), in real terms this amounted to a reduction due to the level of contingency funds that will be needed to ensure stability in the system (in order to counteract any potential further increases in non-elective admissions to hospital), as well as the national withdrawal of the Social Care Capital Grant and the ring fence around the use of the Disabled Facilities Grant.

In response, the contingency fund had been capped at £7.5 million. Any funds not used to buffer non-elective admission activity in-year will be re-directed to supporting out of hospital services. Additionally, schemes that had not met their ‘invest to save’ targets would not receive BCF funding in 2016-17. Schemes in receipt of BCF support in 2016-17 would form part of the whole system response to health and social care transformation and be monitored accordingly.

The significant impact of non-elective admissions on the future BCF plan was acknowledged; and would be a main theme of the focus of the BCF Delivery Group & Partnership Board during 2016-17.  Additionally, the report outlined a proposal for the BCF Delivery Group/Partnership Board to engage both the Clinical Senate and Leeds Institute for Quality Healthcare (LIQH) for appropriate analysis and advice from a practice perspective to support the aim to reduce the level and cost of avoidable non-Elective Admissions.

Steve Hume and Cath Roff, LCC Adult Social Services, further emphasised the impact of both non-elective admissions and the delayed transfer of care on the fragility of the system and the overall impact of funding changes, including tariffs and the ‘invest to save’ funds.

Discussion followed on the impact of mid-year restricted funding which occurred during 2015/16 on the delivery of some schemes. Comments were noted on how the subsequent gaps in service provision were met with responsive stand-alone schemes and that the various responsive pathways into care now required review as better integration was required to plan for such instances. Additionally the need to ensure all schemes proposed to the BCF met all of the BCF criteria was emphasised. The Board also acknowledged the real tension between the requirements of the BCF, national evidence and actual knowledge of the local services.

Members also noted comments made that whilst discussing the 2016/17 BCF, the Board had also just considered the Leeds Health and Wellbeing Strategy and the STP, both of which are 5 year plans. In light of this and the changing national requirements, the Board noted the importance of system leaders ‘holding their nerve’ in order to deliver on the longer term strategic outcomes of the city.

(Councillor Yeadon joined the meeting at this point and requested that her support as Executive Member for Children and Families for the Leeds Health and Wellbeing Strategy be formally recorded. Additionally, Councillor Yeadon reported the support of Children’s Services for the Strategy and gave apologies for Nigel Richardson (Director of Children’s Services) who was attending a meeting of Scrutiny Board (Children’s Services)

RESOLVED

a)  To note the priorities and commitments described in the Plan.

b)  That, having considered the BCF Plan, approval be given to the Plan prior to final submission on the 3^rd May 2016.

c)  That the proposal to engage the Clinical Senate and Leeds Institute for Quality Healthcare (LIQH) in reviewing the level of Non-Elective Admissions from a practice perspective be endorsed