Agenda and minutes

Apologies for absence were received from Councillors Mrs P A Bradwell (Executive Councillor Adult Care and Health Services, Children's Services), and S M Tweedale, Debbie Barnes (Executive Director of Children's Services), Dr Vindi Bhandal (South West Lincolnshire Clinical Commissioning Group) and Mr Andy Leary (NHS England).

It was noted that Sally Savage (Chief Commissioning Officer) had replaced Debbie Barnes (Executive Director of Children's Services) for this meeting only.

There were no declarations of members' interests declared at this stage of the meeting.

(To receive a report from Glen Garrod, Director of Adult Care, which requests the Board to consider the final Better Care Fund Re-Submission)

Consideration was given to a report from the Director of Adult Care, which sought the Boards views on the Better Care Fund (BCF) re-submission to represent the combined and shared ambition across the health and social care community in Lincolnshire.

The Board were reminded that the previous submission document (BCF Part 1 and 2) had been approved by them at their meeting on 25 March 2014 (detailed at Appendix A) along with the agreed allocations in 2014/15, which were also detailed for the Board at their meeting on 10 December 2013.

However, since then the policy direction nationally for 2015/16 was changed in direct consequence of NHS concerns relating to the allocation of funding (notably the NHS element of the £3.8bn) and whether this would deliver improvements and efficiencies required, notably in the acute sector.  As a result of this CCGs were contacted direct by NHS England on 4 June requiring them to resubmit their 2 year plans, by 27 June, in light of concerns raised.

As a result of this, Ministers had not been prepared to sign off BCF submissions in June.  Revised guidance was then issued on 25 July.  On 28 July the Government had then advised Health and Wellbeing Boards that they were required to re-approve and re-submit BCF documents against a substantially changed BCF template by 19 September 2014.  It was highlighted that the new deadline was expected to coincide with Ministers' need to sign off agreed submissions by early October 2014.

The new document shifted the emphasis from pooled budget arrangements towards service developments which would deliver a substantial reduction in emergency (non-elective) admissions at acute hospital sites. The performance element had also been changed from 'avoidable' emergency admissions to emergency admissions.  The new template also requires a section to be completed by the Chief Executive (CEO) of the local Acute NHS (ULHT) Trust to say that they recognised and agreed the expectations and performance targets set out in the BCF submission.  It was highlighted whilst the Acute Trust CEO was required to complete a section of the BCF it was the four CCGs and the County Council that remained the signatories along with the Chairman of the Lincolnshire Health and Wellbeing Board.  It was noted that officers had also approached providers offering them the opportunity to comment and contribute to the submission.

The Director also highlighted that there were also additional risks with the revised approach.  Not least of these was that failure to achieve the desired performance against emergency admissions (a 3.5% reduction in 2105/16) ran the risk of up to £3.7m of the £48m for Lincolnshire potentially being redirected towards the acute sector.  Also, failure to meet the £9m savings target which is the gap between the level of pooled budget available and the current spend by the end of 2015/16 would also require consensus on how this specific risk will be managed across health and social care organisations.

The Board were also advised that  ...  view the full minutes text for item 13.