Agenda item

The Better Care Fund Programme Manager introduced the report which provided an overview of the Better Care Fund Plan and its implications for residents, the Council and its partnership with the local NHS.

Officers explained The Better Care Fund (BCF) was a national initiative intended to deliver integration between health and social care in order to improve outcomes for residents. 

The key objectives of this initiative were:

·         Individuals with care needs receive more joined up care

·         That the independence of residents is maximised or maintained through better prevention and early intervention

·         Scarce resources are used more effectively

·         There are joint plans with agreed priorities to achieve a greater positive impact for local people.

It was noted that the BCF was a mechanism being used by the Government to implement the new integration duty under the 2014 Care Act, which came into effect on the 1^st April 2015. In terms of financial implications, the BCF did not provide new money for Hillingdon; it was about creating efficiencies through integration to ensure that existing funding was used more effectively.

The Committee were informed that the Plan had gone through several iterations during 2014/15 and the final Plan was agreed by the Chairman of the Health and Wellbeing Board and the Chairman of HCCG's Governing Body on the 9th January 2015.

Officers explained the focus of Hillingdon's Plan was on the 65 and over population, which was a reflection of the increasing demand placed on local authority and NHS services by an ageing population.  Its main aim was to reduce the number of emergency admissions.

 The development of integrated IT systems across health and social care is a key enabler to the effective delivery of many of the schemes in the plan and to achieving the position where residents with care needs only have to tell their story once.  The ultimate goal is to have systems that enable partners involved in a resident's care (including third sector) to update their care plan electronically to reflect their respective interventions.  Technological and information governance complexities mean that this goal could take up to three years to achieve. 

In terms of performance metrics, the Committee heard that were six key performance indicators within Hillingdon's BCF plan and the Council was required to report on its performance to NHS England on the following:

1. Emergency admissions - Reduction in emergency admissions per 100,000 65 and over
2. Residential admissions - Reduction in permanent admissions of older people (65 and over population) to residential and nursing care homes per 100,000 population.
3. Reablement - Proportion of older people (65 and over population) who were still at home 91 days after discharge from hospital into reablement.
4. Delayed transfer of care (DTOC) - Delayed transfers of care (delayed days) from hospital per 100,000 (aged 18 and over).
5. Service user experience - In the past year, how easy or difficult it has been to find information and advice about services or benefits.
6. Local metric: Social care-related quality of life - Questions about 8 quality of life issues covering control over daily life, personal care, food and nutrition, accommodation, safety, social participation, how people spend their time and dignity.

Officers explained that the delivery of the Plan would be overseen by the Health and Wellbeing Board (HWBB), which would receive quarterly performance reports.

Discussing the advantages of the Plan, the Committee were encouraged to learn that closer working between partners across health, social care and the third sector had resulted in a 7% drop in the number of emergency admissions to hospital from care homes in December 2014 when this would be expected to rise. In addition, closer working between agencies had seen a speedier discharge of patients from the emergency department at Hillingdon Hospital and the Hawthorn Intermediate Care Unit (HICU) back into the community.

Acknowledging the pressure created by an ageing population would increase over time, the Committee asked Officers what provisions there were to meet future targets. In response, Officers explained that part of the approach focused on new ways of working as well as anticipating future issues. Officers also confirmed that they were investigating alternative options for dementia care and a range of other care opportunities.

In relation to the market place, Officers confirmed that access to information was provided by a portal entitled 'Connect to Support'. This web based directory of services also provided forms of online assessment, advice and advocacy. 

Discussing the likelihood of a universal care plan, the Committee asked Officers what a likely timescale for this might be. In response, Officers confirmed that while new protocols were being developed to significantly enhance information sharing, a single care plan was not on the immediate horizon.

Resolved -

1.    That the report be noted