Agenda item

Purpose of report:

To update the Board on the current position of the Better Care Fund (BCF) and on future BCF allocations.

Witnesses:

Helen Atkinson, Strategic Director for Adult Social Care and Public Health

Sian Kenny, Transformation and Development Manager, Finance

Mel Few, Cabinet Member for Adult Social Care, Wellbeing and Independence

Tim Evans, Cabinet Associate for Adult Social Care, Wellbeing and Independence

Declarations of interests:

None

Key points of discussion:

1. Officers outlined that there were a number of future Better Care Fund (BCF) allocations. The Board was informed that in addition to the BCF and Improved BCF allocations that a third funding stream had been announced by the Chancellor of the Exchequer on 8 March 2017. It was noted that the service was awaiting guidance from central government regarding the Chancellors announcements.
   
   
2. It was highlighted by officers that the service was forward planning using existing funding streams for 2017/18, due to the recent nature of changes.
   
   
3. Officers noted that the third workstream was estimated to contain approximately £7.5 million which was ring-fenced to fund adult social care (ASC).
   
   
4. It was explained by officers that existing BCF funding streams were financed partially by NHS England, under the stipulation that funding from this source is ring-fenced for ASC. The Improved BCF was a funding stream that came from the Department for Communities and Local Government (DCLG). It was noted that planning guidance and policy had not yet been published for the BCF 2017/18 stream. NHS Clinical Commissioning Groups (CCGs) and Surrey County Council were in discussion regarding funding the financial year ahead.
   
   
5. The Cabinet Member for Adult Social Care, Wellbeing and Independence noted that there was a significant funding gap present in the Improved BCF and that this effected all of the Surrey CCGs. It was also noted that the new funding workstream was also a lower amount than its statistical neighbours.
   
   
6. The Board questioned the reasoning for the lower level of funding than its statistical neighbours. The Cabinet Member for Adult Social Care, Wellbeing and Independence expressed the view that central government had determined that Surrey County Council could independently raise funding for ASC through Council Taxes, rather than requiring substantial additional funding.
   
   
7. Members questioned whether the service could provide a breakdown of the funding allocated through the BCF funding streams per head of those in receipt of ASC, in order to better clarify the funding issue in the service.
   
   
8. The Board questioned whether the service could look into reduction of any non-statutory provisions that did not provide additional social or economic value. Officers stressed that there had been work undertaken to determine the social value of spending and that services had already been decommissioned or recommissioned based on this analysis. However, it was highlighted that the service had worked to reduce the majority of services to their statutory requirements.
   
   
9. Officers noted that the service had reviewed voluntary sector grants with the aim of reducing spend. However, Members raised the concern that the social value of this spend was significant, noting that there was a potential for high return on this investment. It was also stressed by Members that significant numbers of community services relied on voluntary service and that reductions in this area could adversely affect service quality. Members also expressed concerns that some voluntary organisations could become unviable without support. However, Members did suggest that the service needed to look critically at the voluntary sector to ensure that resources are targeted at need more effectively.
   
   
10. Members raised concerns regarding Alzheimer’s UK and the closure of centres. The Cabinet Member for Adult Social Care, Wellbeing and Independence noted in response to concerns raised by Members that the decision to do this was made by Alzheimer’s UK in response to a lack of demand for services and that Surrey County Council had no responsibility for this service.

Recommendations:

The Board recognises the value of the BCF in ensuring the protection of social care services, in ensuring closer integration with health services such as supporting improved discharge in acute hospitals.

It notes that the improved BCF formula places the County at a financial disadvantage. It recommends:

1. That the Cabinet continue to make representations to central government on an improved BCF formula based on need, rather than the council’s ability to raise council tax.