Agenda item

Officers were thanked for the work that had completed so far and it was noted that further work was still required.  The Better Care Fund performance report covered a subset of the activities undertaken by partners and, although the format was similar to Cabinet reports, the quality needed to be improved. 

The Board was advised that £1m had been included in the budget for Care Act new burdens.  However, it was important to ensure that this was monitored and managed and that any discrepancies were identified so that next year's budget was as accurate as possible. 

It was noted that some of the causes of delayed transfers of care (DTOC) were known about in advance, e.g., a patient not wanting to be moved to a care home.  To mitigate this delay, Integrated Assessments were now undertaken with the patient and their family at the start of the process rather than towards the end.  Although these discussions were undertaken as early as possible, they could often be protracted, which contributed to delays. 

The Hillingdon Hospitals NHS Foundation Trust (THH) was familiar with those patients that were regularly readmitted to hospital.  Mr DeGaris noted that the Trust's objective was to get these patients back home as soon as practicable with the support that they needed in place.  However, as patients with escalating crises would not benefit from this help, the possibility of moving into a care home had to be discussed.

The Board noted that, with regard to DTOC, there were issues regarding people with mental health issues in that they were sometime difficult to locate due to their lifestyle.  As such, consideration was being given by CNWL to investment in housing stock and additional secure locked beds.  It was anticipated that the development of an integrated care plan template would assist with care planning and care coordination across all partner agencies. 

Hillingdon Clinical Commissioning Group (HCCG) advised that many of the services that it commissioned were block contracts which resulted in a predictable one twelfth of the budget for these services being spent each month.  It was noted that a blcok contract would have to significantly over or under perform to trigger a discussion.  It was agreed that HCCG would include information about the activity of these contracts in future reports to the Board.  A decision had not yet been made about the additional funding that could run alongside this as it was still going through the governance process to ensure that it was deliverable.  It was agreed that the Board also be provided with:

·         a rough breakdown of the overspend from the Council and HCCG in relation to rapid response and joined up intermediate care to identify activity and possible improvements;

·         detail of the outturn in relation to seven day working;

·         a breakdown of, and reasons for, the overspend from the Council and HCCG in relation to the review and realignment of community services to emerging GP networks;  and

·         a breakdown from Council officers of the calculation of the £1,686k outturn in relation to the Care Act implementation.

RESOLVED:  That the Health and Wellbeing Board:

1.    noted the contents of the report.

2.    approved the increase in the permanent admission to care homes target for 2015/16 from 104 to 150.

3.    would receive information about block contract activity in future HCCG reports.

4.    receive the additional information as detailed in the minute.