Agenda item

Consideration was given to the report in relation to the Better Care Fund plan.  It was noted that feedback had been received from NHS England and the Local Government Association in relation to the Hillingdon Better Care Fund (BCF) draft plan.  The revised plan provided high level information in relation to 11 schemes with an emphasis on the frail and elderly.  It was noted that the plan would need to be translated into an action plan that would specifically meet the needs of the Borough.  To this end, it was recognised that residents should be engaged in the process.

Furthermore, it was agreed that an additional aim/objective be included in plan with regard to engagement (Section 2b).  Namely, "we will ensure that we undertake regular engagement and communication with residents to show progress against all aspects of the plan."  It was also agreed that, in the governance section of the plan (Section 2e), the phrase "The board therefore takes full strategic oversight for health and care systems in the Borough..." be amended by deleting the word "full".

With regard to the administration of the BCF budget, it was suggested that this be undertaken by the Council.  The Board noted that the BCF budget would sit with the Health and Wellbeing Board and, as the Board had been formed as a Committee of the Council, it was a logical step for the administration of the budget to be undertaken by the Council.  Significantly, this would also mean that the Council would be directly accountable for any consequences.  However, it was acknowledged that a governance structure would need to be put in place below the Board to provide assurance to the partners. 

Concern was expressed that, with regard to the administration of the budget, consideration would need to be given to practical issues such as the Section 75 agreement.  Section 75 partnership agreements allowed budgets to be pooled between local health and social care organisation and authorities.  Alignment of the different organisations' working practices would need to be worked through.

It was noted that risks, and the proposed mitigation, had been identified within the plan (Section 4).  Of these risks, it was agreed that further consideration would need to be given to the implications of the proposed eligibility criteria and how this would work locally. 

It was suggested that the composition and terms of reference of the Health and Wellbeing Board Sub Committee be revisited to include responsibility to review the risks identified in the BCF plan.  It was anticipated that this would help to ensure that, during the course of the next municipal year, further improvements were made to the plan prior to its implementation in 2015/2016. 

It was thought that the governance arrangements and reconfiguration of the Sub Committee membership and redrafting of its terms of reference would be key to the success of BCF in Hillingdon.  As a way forward, it was suggested that a formal or informal Executive Group be set up to comprise the CCG Chairman (plus one other representative) and the Leader of the Council (plus one other representative).  This Executive Group could then be used to discuss any issues addressed by the Sub Committee that had proved challenging.  It was agreed that finance officers could be included in the membership.  Board members were asked to come forward with their thoughts on this as soon as possible so that appropriate action could be taken. 

It was recognised that the BCF was providing the Borough with an opportunity to do things differently.  It was suggested that it would be helpful to resolve the logistical considerations within the next 3 months.  

RESOLVED:  That:

1.    the Board agrees the Hillingdon Better Care Fund (BCF) plan and the financial summary at Appendices 1 & 2 for submission to NHS England and that the BCF budget be administered by the London Borough of Hillingdon;

2.    the Board instructs the core officer group to develop business cases and implementation plans for the 11 schemes, in accordance with the governance  arrangements in the plan, for discussion at the Board's next meeting on 17 June 2014; and

3.    the composition and terms of reference of the Health and Wellbeing Board Sub Committee be revisited.