Agenda item

Purpose of report: To update the Board on the final Better Care Fund plan for 2016/17 and invite it to consider how it monitors its delivery in conjunction with the wider health and social care integration agenda.

Witnesses:

Helen Atkinson, Strategic Director for Adult Social Care and Public Health
Mel Few, Cabinet Member for Adult Social Care, Wellbeing and Independence
Dominic Wright, Chief Executive of Guildford and Waverly CCG

Key points of discussion:

1.    The Strategic Director for Adult Social Care and Public Health explained to the Board that the Better Care Fund (BCF) was part of a wider integration between CCGs and the Council. It was also highlighted that these plans were expected to work in collaboration with the NHS five year forward view, and the locally developed NHS Sustainability and Transformation Plans (STPs). The Board was informed that the integration agenda was seeking to improve preventative services, in order to reduce demand on the NHS.

2.    The Board was informed that the pooled BCF budgets enabled the two organisations to achieve closer integration and realise efficiencies through this.

3.    The Board queried what challenges existed in delivering the BCF plans. Witnesses commented that there was a significant difference in cultures between the two organisations, though it was highlighted that the past few years had seen closer working together. The developing digital roadmap and information sharing that was underway was highlighted as a good example of this.

4.    The Cabinet Member for Adult Social Care, Wellbeing and Independence explained that there were a number of common problems faced by both organisations with regard to workforce development. It was highlighted that the two organisations would work collaboratively to address this.

5.    The Board queried how the metrics for measuring the delivery of the BCF had been established. Officers explained that these metrics were generally set nationally by the NHS, however that some were able to be set at a local level. The Board was informed that a locally chosen measurement for Surrey was the prevalence of dementia cases.

6.    A question was put forward by the Board regarding the voluntary sector of care, and whether it can realistically provide care with reduced funding, and queried how the service is forward planning to meet this contingency. The Strategic Director for Adult Social Care and Public Health reassured the Board that the service was working with partners to ensure that these issues were resolved. It was explained that any decisions made financially must be made in partnership and that the service was building relationships with local business and charities to reduce risk.

7.    The Board commented on the complex structure of CCGs and questioned why there were presently three STPs covering the region rather than one. It was explained that there  was not a cohesive boundary in Surrey evolving for the STPs, and that these had been decided centrally by NHS England. It was, however, clarified that these boundaries were permeable to encourage interconnectivity and that the CCGs were working closely with the Council to ensure that they are closely linked.

Recommendations

1.    That the Board monitor the financial position of the Better Care Fund as part of regular service budget updates to the Performance and Finance sub-group.

2.    That a further joint session on the Sustainability and Transformation Plans is scheduled for late 2016/17.

3.    That the Wellbeing and Health Scrutiny Board chairman seek to secure Member representation at a suitable level within the three STP governance structures.

4.    That the Wellbeing and Health Scrutiny Board cover the changes that NHS England will be making (for example in joint commissioning of Primary Care and in development of the clinical workforce).

5.    That a joint Social Care Services Board and Wellbeing and Health Scrutiny Board four person monitoring group is established to oversee how the BCF and STP plans and delivery progress, with a particular focus on.

a.    Information sharing across the organisation

b.    Social care and NHS staffing

To report back to the joint session in late 2016/17