Agenda item

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that the draft 2022/23 Better Care Fund (BCF) plan had been submitted on 26 September 2022 and that the outcome of the assurance process was expected by 9 December 2022.  It was understood that the Government would require a two-year plan in future and that the policy framework and planning requirements would be published in Q4.  It was anticipated that a delayed transfer of care measure would return and the Board would be updated on this once more information had been received. 

It had been announced that Hillingdon had been awarded £867.5k from the Hospital Discharge Grant and that North West London Integrated Care System (NWL ICS) had been allocated £8.91m but it was currently unclear how much of this would be spent in Hillingdon.  To enable the grant to be spent by the end of the financial year, a spending plan would need to be submitted by 16 December 2022, included in the Section 75 agreement and agreed by the Health and Wellbeing Board.  Because of the tight timescales, it was agreed that formal approval be delegated to the Council’s Executive Director of Adult Services and Health in consultation with the Co-Chairmen of the Board and the Joint Borough Director at NHS NWL.  The Board was advised that the report concerning the 2022/23 BCF section 75 agreement being considered by Cabinet on 15 December 2022, would contain arrangements to ensure compliance with the national hospital discharge fund requirements. 

With regard to Workstream 3: End of Life Care, Mr Collier noted that Hillingdon had done very well with the lowest percentage of deaths occurring in hospital over the twelve month period to August 2022 out of the four Outer North West London boroughs. 

The Board was advised that care market management and development was one of the five enabling workstreams supporting the sustainable delivery of the six workstreams.  This work had identified that A&E attendance in Hillingdon had been slightly lower than that of 2021 during the April to September period, but above the average for NWL and needed further analysis.  One of the main causes of London Ambulance Service (LAS) attendance at care homes and subsequent conveyances and admissions to hospital continued to be falls related injuries.  However, the report showed that Hillingdon care home use of the NHS 111*6 service was the second highest in NWL and might have contributed towards preventing avoidable attendances at A&E and unnecessary demand on the LAS. 

Professor Ian Goodman, NWL ICS, noted that “the average waiting for surgery for older people had increased from 145 weeks in April 2022 to 166 weeks in October” and that a wait for over three years was shocking and needed to be addressed.  The Co-Chairman (Councillor Palmer) asked that further investigations be undertaken into this waiting time.  Mr Keith Spencer, Managing Director at HHCP, advised that he and Mr Richard Ellis would work with Hillingdon Hospital to establish what was going on.  The Co-Chairman advised that it was disappointing that Ms Patricia Wright, Chief Executive of The Hillingdon Hospitals NHS Foundation Trust, had been unable to attend and that, if members of the Board had to give their apologies, it was important that they sent a substitute in their stead who could make decisions on their behalf.  [NOTE: After the meeting, it was noted the information included in the report had been incorrect and should have read: “the average waiting for surgery for outpatients had increased from 145 days in April 2022 to 166 days in October”.]

RESOLVED:  That the Health and Wellbeing Board agrees that the formal approval of the Hospital Discharge Fund spending plan be delegated to the Executive Director, Adult Services and Health in consultation with the Health and Wellbeing Board Co-Chairmen and the Joint Borough Director, NHS North West London on behalf of the Board.