Agenda item

(To receive a report from Glen Garrod, Executive Director Adult Care and Community Wellbeing concerning the 2017/18 – 2018/19 Better Care Fund submission)  

Consideration was given to a report from Glen Garrod, Executive Director of Adult Care & Community Wellbeing on behalf of the Joint Commissioning Board, which provided the Board with an update on Lincolnshire's Plan for updating the Better Care Narrative Plan and Planning Template for 2017/18 and 2018/19.  Documents appended to the report included:-

·         Appendix A which provided the Board with an update on performance against the key BCF metrics for the first nine months of 2016/17;

·         Appendix B provided a copy of the Lincolnshire County Council Internal Audit paper, which had reviewed BCF Performance reporting; and

·         Appendix C which provided the Board with the latest version of the draft Graduation Plan.

The Executive Director of Adult Care & Community Wellbeing when guiding the Board through the report made particular reference to:-

·         That the Better Care Fund guidance had still not been received;

·         That in tier two areas there were additional challenges; and that all had a contribution to make;

·         That the BCF was for two years, and that there was to be further changes in next 12 months;

·         The Board was advised that it was expected that in the budget speech the Chancellor would be announcing there would be extra money for social care;

·         That there was still a need for improvement for non-elective admissions (NEA); the local target was for a 2.7% reduction.  It was noted that for the first six months a reduction of 1.6% had been achieved;

·         That for permanent admissions to residential and nursing care there had been 105 more than planned for at this point in the year;

·         That for Delayed Transfers of Care there had been a total of 9,503 delayed days for patients in Q3, this figure was 2,078 higher than the original target of 7,425 days.  It was further highlighted that nationally performance was worsening in key targeted areas, notably non-elective admissions and Delayed Transfers of Care.  Detailed information in relation to the two areas was detailed at the bottom of page 63 and the top of page 64 of the report presented.  It was reported that a £3.6m Risk Contingency had been established to address the financial impact of not achieving the NEA target.  The Board was reminded that the Council was currently assuming that there would be no Pay-for-Performance requirements in 2017/18;

·         The extra complication with regard to Disabled Facility Grants.  It was hoped that the BCF Planning Guidance would hopefully provide some clarity on the arrangements for DFGs; and

·         The Board noted that a Graduation Submission had been prepared by Lincolnshire, a copy of which was detailed at Appendix D to the report. 

During discussion, the following issues were raised:-

·         Page 72 of Appendix A – Better Care Fund 2016/17 Performance Report – Quarter 3 – A suggestion was made that District Councils might be able to help with regard to housing issues.  It was noted that the performance reflected the national template set by government;

·         It was highlighted that any housing delays were discussed with Districts and the NHS.  It was noted that relatively few delays were as a result of DFGs, or for the need of specialist equipment.  Some Councils elsewhere in the Country did however apply a fastrack process; and

·         It was reported that some patients had encountered some problems when leaving hospital, an example given was concerning a patient that had spent a year in a nursing home, as social care had no suitable care packages available. The Board was advised that the Council had a small number of patients in nursing homes, just so that the hospital system could be freed up.  It was highlighted that the pressure on hospitals now was significant, as now all patients leave hospital as soon as possible.  It was felt by some members that the 30 day turn around was just shifting the pressure on to another area. 

RESOLVED

1.    That the BCF performance as detailed at Appendix A for the first nine months of 2016/17 be noted.

2.    That the performance achieved on Non-Elective Admissions in the first nine months of 2016/17 it is recommended by the Joint Commissioning Board that £3m Risk Contingency established for this financial year will be fully utilised by the CCGs in meeting the extra cost to ULHT be noted.

3.    That the Internal Audit Report at Appendix B on performance reporting be noted.

4.    That the updated draft Graduation Plan at Appendix C be noted.