Agenda item

Gary Collier, Health and Social Care Integration Manager, introduced a report updating the Committee on the Better Care Fund Plan 2017-19. Mr Collier was supported by Joan Veysey, Deputy Chief Operating Officer - CCG.

The Committee was advised that the Better Care Fund Plan (BCF) for the 2017/19 period was Hillingdon's third plan, and had now been approved by NHS England.

The report outlined Hillingdon's performance against National Metrics, set by NHS England. While several targets had been missed, it was important to evaluate performance to target within the context of an aging population with increased complexity of need, and in these terms Hillingdon had done well to contain the level of growth and demand seen in the period. However, there was work still to be done to ensure performance continued to improve.

While it had not been possible to deliver some of the key actions set out for the period 2016/17, much of the development work had taken place to help facilitate the delivery major of initiatives to be taken forward during the period 2017/19, such as integrated brokerage and integrated homecare.

Members sought clarity on a number of points including:

How were the delays in supporting the discharges from hospital for people with mental health needs being addressed?

Processes to address the discharge of those with mental health issues were now being instigated much earlier. A new discharge management tool was now being used, which included regular meetings between mental health officers and housing officers. Whilst this was still a work in progress, improvements were starting to be seen.

In addition, it was important to recognise that the data in the report set out the number of days that patients were delayed from being discharged, but not the number of individuals affected. People requiring specialist help were a relatively small number, but were often more challenging to find a suitable home setting and therefore could take a significantly longer amount of time to be discharged, thereby skewing the figures somewhat.

Why was Hillingdon still considering joining the Accountable Care Partnership (ACP)?

This was related to the development of a business case, as the Council was required to be certain that there were no undue risks to the Council.

NHS England required that the final BCF Plan was published by 11 September 2017. Why had Hillingdon missed this deadline?

Delays in publication were caused by local governance processes. The submission process guidance had been published by NHS England in July 2017, with templates submitted later. Hillingdon was therefore required to develop the Plan in August 2017, and were not in a position to seek approval of the Plan until the meeting of the Health and Wellbeing Board in September 2017. Hillingdon was not the only authority in such a situation, and had been in regular dialogue with NHS England throughout the process.

What was the reason for the decline in the emergency admittance of people aged 65 and over since 2014/15?

This was in large part due to the increased effectiveness of early identification and the addressing of needs prior to them becoming emergencies, through primary care settings (GPs) and the use of the Care Connection teams.

How was the initiative to electronically share data between Local Authorities progressing?

This was proving to be a challenge, though was still being worked on. Members would be kept informed of the progress to delivery.

Were there any challenges not set out within the report?

Challenges included the complexity of the landscape, and the need to change organisation and patient culture while having a finite care workforce. The number of people requiring care was increasing, and it was challenging to ensure that the requisite number of people were in place to effectively manage that care. 

Were there any other areas identified that could host a local dementia resource centre, similar to Grassy Meadows?

The Wren Centre was Hillingdon's current resource centre, and it was intended to move to Grassy Meadows in June 2018. Grassy Meadows would include 88 self-contained flats and included 24/7 on-site care and support provision.  Grassy Meadows was located centrally within the Borough, and would be used by local voluntary organisations for their own activity sessions.

Park View in West Drayton was a second site, comprising 60 flats, to open in September 2018. Park View, similar to Grassy Meadows, would include on-site care and provision.

Work was being undertaken to connect with local GPs, the Care Connection team, and third sector voluntary groups, to publicise the facilities at the sites and build a full programme of services and activities for the whole year.

Members provided feedback on behalf of residents, who were very pleased with both the Wren Centre and Yiewsley & West Drayton Community Centre, praising the timetable of activities and the caring and attentive staff. However, it was requested that further efforts be made to contact residents awaiting transport to the sites, in the event of a delay. Officers confirmed that there were mechanisms in place to contact waiting residents, and requested that further detail on specific cases be provided outside of the meeting.

Members requested that future reports include details of Hillingdon's performance to targets versus statistical neighbours. Officers agreed that this would be looked into.

RESOLVED:  That:

1.    The report be noted; and

2.      That the feasibility of including performance data against statistical neighbours be provided in future reports.