Agenda item

The Panel received a report on the progress of the Better Care Fund (BCF) for the period since April 2015 when the programme become fully operational.  The BCF aimed to improve social care by integrating activity to reduce emergency admissions and urgent health demands.  The Council and Slough Clinical Commissioning Group (CCG) had agreed a pooled budget of £8.762m for 2015/16 to support this activity.

(Councillors Shah and Pantelic joined the meeting)

Members received a comprehensive update which can be summarised as follows:

• Five Year Plan – the BCF programme contributed to the Five Year Plan outcome of more people taking responsibility and managing their own health, care and support needs.
• Pooled Budget – an estimated 85% of BCF activity was existing services transferred into the pooled budget.  New activities coming through were assessed on the basis of a robust business case.
• Finance – the key financial risk would be the failure to meet the targeted 3.5% reduction in non-elective admissions, which had been made even more challenging as a higher baseline had been set for Slough.  It was expected that there was sufficient contingency available to mitigate this risk, however, failure to reach the target would reduce the resources available for additional activity.
• Risk register – the risk register was regularly updated.  The key risks were that the activity did not translate into the required reductions in acute admissions, thus impact on the funding available; the uncertain financial outlook for health and social care; and the impacts of the Care Act and wider social care reform.
• Proactive Care – GPs were carrying out risk profiling activity on patient data to identify their most vulnerable patients to improve targeting of early intervention.
• Single Point of Access – good progress had been made to establish a single point of access for community health and social care services which would be made available for professional referrals in the first phase before being opened up more widely.
• Community Capacity – a Joint Voluntary Sector Strategy had been developed and subsequent recommissioning programme was underway.

The Panel asked a number of questions and considered key aspects of the report in detail.  The way that patients accessed care and support across boundaries, including through the Single Point of Access was discussed. Members were informed that there was substantial cross border collaboration between Slough and neighbouring authorities to meet people’s care needs.

The report referred to work underway across East Berkshire to improve data sharing arrangements, including the procurement of a new IT system to provide part of patient records to health and social care services.  A Member commented that previous data sharing programmes had not been successful including difficulties introducing new IT systems.  It was suggested that clear performance targets and sanctions be put in place with the software supplier in the event the system failed to meet its objectives.  The risks in introducing any new IT system were recognised but significant development work on the specification and information governance arrangements were taking place.  It was also noted that a pilot scheme was running partly to identify and resolve technical issues.

The Panel asked a number of questions about the performance, monitoring and auditing arrangements of the BCF programme.  It was noted that the BCF programme clearly set out the Key Performance Indicators and reporting arrangements.  It would also be independently audited and a management action plan would follow from the audits.  Members noted that it was early in the programme to fully evaluate performance, but that good progress was being made on a number of key indicators such as reducing delayed transfers of care, admissions to residential care and reablement services.  Performance against the non-elective admissions indicator was a key challenge as it had increased 5% in the year to March 2014 with a target reduction of 3.5% for 2015/16.  The Panel asked for a summary of more detailed performance information and metrics on BCF projects/outcomes to be including in future reports and that Members be kept informed of both what was working well and what wasn’t as delivery of the programme was rolled out.

Engagement of the voluntary and community sector was also discussed and it was noted that the new Voluntary Sector strategy provided the platform for engagement with the sector to improve the alignment of activity and outcomes.

Members asked what more the Panel could do to support the delivery of the programme.  A new evidence based programme on falls had recently been approved and Members could assist by spreading the message to local residents and communities.  It was agreed that further information on new falls project would be circulated to Members of the Panel to enable this.

A question was asked about progress in addressing alcohol abuse and good practice was highlighted from Pendle.  It was responded that significant work was being undertaken and it was suggested a report on these matters be added to the Panel’s forward work programme.

At the conclusion of the discussion, the Panel thanked officers for the update and noted the report.

Resolved –  That the update on the Better Care Fund programme be noted.