Agenda item

Mr Gary Collier, the Council's Health and Social Care Integration Manager, advised that the value of the Better Care Fund (BCF) submission in 2023/24 had been £96.5m, which had been a reduction from £109m in 2022/23 (this had largely been attributed to a reduction in the Integrated Care Board voluntary contribution).  The provisional value for 2024/25 was £98.5m. 

Feedback had been provided by the Assurance Team with changes to the Avoidable Admissions target (which would make the target less challenging to achieve in 2023/24) and a correction to the rationale supporting discharge to the Usual place of residence metric (which did not affect the target).  Additional text had been added to the narrative plan document that supported data in the demand and capacity worksheet in the submission template.  Changes had also been made to the demand figures to reflect those individuals that needed low level assistance.  Once confirmation of assured status had been received, a Section 75 legal agreement could be entered into which would satisfy the final BCF national condition by the end of November 2023. 

The Co-Chairman commended Mr Collier and his team for the excellent work that they had undertaken during a very difficult period.  She gave her personal thanks for this very comprehensive piece of work.  Professor Ian Goodman, North West London Integrated Care Board, suggested that further work be undertaken to reflect the changes in the percentage of patients presenting at A&E that had been admitted compared to attendances.  Mr Jason Seez, Deputy Chief Executive at The Hillingdon Hospitals NHS Foundation Trust, advised that Hillingdon Health and Care Partners would need to do a deep dive into this and then take it back to their Board. 

With regard to the metric for Discharge to normal place of residence, Professor Goodman noted that this had been 92.18% in Quarter 1 against a target of 92.8%.  However, Homefirst/Discharge to Assess Pathway 2 figures showed that 4% of hospital discharges went into rehabilitation or short-term care in a 24-hour bed-based setting and Pathway 3 figures showed that 1% required ongoing 24-hour nursing care in a bedded setting.  This would suggest that the metric for Discharge to normal place of residence should be 95%, not 92%.  Mr Collier advised that these figures had been provided by different sources.  He would investigate the discrepancy and share this information with the Board.

Mr Collier noted that this year had not been without its challenges with reviews of the BCF scheme.  The report set out the parameters for the North West London (NWL) review of schemes which would be undertaken by an external organisation.  It would be important that the need to address the key lines of enquiry within the BCF planning requirements was not lost within this process.  In addition to the work undertaken at a NWL level, a place-based review would be undertaken locally in relation to out of hospital spend.  It was anticipated that this would be completed by the end of October 2023.  Results of both reviews would be reported back to the Board at its meeting on 28 November 2023.  The Chairman noted that an apology had been received about the way in which the BCF had been handled at a NWL level and that it would not be like this in the future. 

Mr Tony Zaman, the Council's Chief Executive, noted that the BCF had been reported to the Health and Wellbeing Board since about 2013.  During this time, Mr Collier had put a lot of effort into the BCF which had put the Borough in a good position that would define the future.  This work had put Hillingdon ahead of the game and meant that the NWL review could be seen as a positive experience rather than a threat.  He stated that the positive results seen in the Borough were thanks to Mr Collier and an excellent example of partnership working. 

RESOLVED:  That the report and update provided by officers be noted.