Agenda item

The purpose of this item is to Update the Board on progress in implementing the Better Care Fund plan 2015/16 – annexed to this cover report are the Q2 and Q3 Better Care Fund returns made to NHS England and present the draft Surrey Better Care Fund plan for 2016/17 – the Board is asked to comment on and endorse the plan, and to delegate authority for it to be finalised and submitted to NHS England on the Board’s behalf.

Witnesses:

Helen Atkinson, Strategic Director Adult Social Care and Public Health, Surrey County Council

Key Points raised during the discussion:

1.    The report was introduced by SCC’s Strategic Director for Adult Social Care and Public Health who highlighted the significance of the Better Care Fund (BCF) in delivering integration between health and social care services in Surrey. Members were shown a video on Surrey’s collaborative Reablement Services as a demonstration of how the BCF was improving patient outcomes and reducing cost.

2.    The deadline for submitting the final version of Surrey’s BCF plan for 2016/17 to NHS England was 28 April 2016. Members were advised that some minor amendments would be required to the draft BCF plan included in the agenda ahead of the final submission. The Board was informed that the BCF 2016/17 plan would not differ significantly from the 2015/16 submission as a result of NHS England’s requirement for Clinical Commissioning Groups (CCG) to produce Sustainability and Transformation Plans (STPs) as it was felt that these would replace the BCF as the main drivers for change in health and social care delivery over the coming years.

3.    Members were told that investment in the BCF for 2016/17 would increase by £2 million from the previous year. It was, however, highlighted that this additional funding for the BCF would come from existing CCG and SCC budgets by savings generated through health and social care integration. The Board was further informed that the financial principles for BCF funding in 2016/17 had been agreed and that this would enable health and social care integration to be scaled up. A key aspiration for the BCF in 2016/17 was to deliver hospital discharge and reablement services which were open from 8 till 8 seven days a week. It was noted, however, that Surrey had performed well on Delayed Transfers of Care (DTOC) when compared to other local authority areas in England and Wales.

4.    The Board was advised that discussions were also taking place between SCC and Surrey’s 11 District and Borough Councils in regard to agreeing funding allocations for the disabled facilities grant.

5.    Members drew attention to the target for the reduction in non-elective hospital admissions as outlined in the BCF draft plan. It was suggested that a 7% reduction in non-elective hospital admissions in the first quarter of 2016/17 was an ambitious target and the Board asked whether it was realistic. The Strategic Director advised members that Surrey had been asked to target a greater reduction in non-elective hospital admissions. Members were informed that a 7% reduction in the first quarter would be challenging but was certainly achievable; some CCGs would perform better than others in decreasing non-elective admissions and it was anticipated that collectively this would average out to meet the 7% county-wide target. The Board asked to be shown the methodology and detail in relation to non-elective admissions targets regarding 2016/17 BCF metrics.

6.    Discussions took place regarding the extent to which the express aim of the BCF to encourage closer working between health and social care had been achieved in Surrey. Members acknowledged that the first year of the BCF had been challenging due to the way in which the Government had made health and social integration mandatory without making any additional financial resources available with which to achieve this. This had led to difficult conversations between health and social care commissioners in Surrey, as it had nationally, as a result of the budgetary pressures. Despite these challenges, SCC and the CCGs had worked collaboratively in order to deliver joint plans for the implementation and delivery of integrated health and social care services across the County.

7.    The Board discussed how Sustainability and Transformation Plans could be effectively communicated to engage residents in the development of STPs and ensure that the aims and objectives of these were accurately understood. Members were advised that the each STP would be supported by a communications strategy to ensure that partners were effectively engaged. The Board highlighted the need to demonstrate to residents that STPs are the next step in creating localism within health and social care delivery. Members asked that the Health and Wellbeing Board Communications Sub-Group give consideration to how consistent messages can be delivered to residents around STPs.

Actions/ further information to be provided:

1.    Health and Wellbeing Board to receive data on how Surrey performs on delayed transfers of care compared to national guidelines.

2.    Health and Wellbeing Board to Show methodology and detail in relation to non-elective admissions targets regarding 2016/17 Better Care Fund metrics.

3.    Health and Wellbeing Board Communications Sub-Group to consider how communications around the delivery of the Better Care Fund could show joint working between health and social care commissioners.

4.    Health and Wellbeing Board Communications Sub-Group to consider how consistent messages on STPs can be delivered to Surrey residents.

RESOLVED: That;

1.      Note the progress made in implementing the Better Care Fund 2015/16;

2.      Comment on the draft 2016/17 Surrey Better Care Fund Plan; and

3.      Endorse the draft plan and delegate authority to the Strategic Director for Adult Social Care & Public Health, Surrey County Council and the Chief Officer, Guildford and Waverley CCG (as co-chairs of the Surrey Better Care Board) to approve the final version of the plan (in consultation with the co-chairs of the Health and Wellbeing Board) for submission to NHS England by 25 the April 2016.