Agenda item

Better Care Fund

(To receive a report and presentation from Glen Garrod, Executive Director Adult Care and Community Wellbeing, which invites the Committee to consider a report on the Better Care Fund, due to be considered by the Executive Councillor for Adult Care, Health and Children's Services, during August 2017.  The presentation will provide background information to enable the Committee to fully consider the item)

Minutes:

Consideration was given to a report by the Executive Director of Adult Care and Community Wellbeing which invited the Committee to consider a report on the Better Care Fund (BCF) due to be considered by the Executive Councillor for Adult Care, Health and Children's Services during August 2017.

 

At 10.07am, Councillor Mrs P A Bradwell joined the meeting.

 

Glen Garrod (Executive Director of Adult Care and Community Wellbeing) introduced the report and gave a short presentation which provided background information on the following areas of the BCF:-

·       The BCF and Lincolnshire:  3 years on;

·       Integration Transformation Fund (ITF)/BCF Funding;

·       Where did the money go?

·       Disabled Facilities Grant (DFG) funding;

·       Signatories;

·       Getting Approval;

·       National Conditions;

·       Planning Overview;

·       Metrics; and

·       Delayed Transfers of Care (DTOC);

 

It was acknowledged that hospitals were under pressure to discharge patients as soon as they no longer required hospital care.  However, there remained a concern that some of these patients would require home care following discharge from hospital and that this took time to arrange.  During that interim period, these patients needed care and it was the decision of social care professionals to confirm if the discharge was appropriate.  Under the Choice Directive, patients also had the right to opt to stay in hospital or accept the care package offered to them.

 

Members were invited to ask questions, during which the following points were noted:-

·       Members agreed that a convalescent type facility appeared to be a potential solution to alleviate the issue of Delayed Transfers of Care (DToC);

·       The Committee was advised that this type of provision would require a considerable amount of capital investment, something which the NHS had included within the Sustainability and Transformation Plan (STP).  It was noted that the final decision for this capital funding request would be for the Department of Health to make;

·       Lincolnshire had submitted a capital bid for £205m although it was noted that the STP in Lincolnshire was moving forward at a slower rate than other areas which gave the Committee cause for concern that the county would miss out on vital capital investment;

·       It was confirmed that a commitment had been made to spend money on a recurrent basis to ensure services continued.  However, some of the BCF funding was non-recurrent and, as some local systems would have used the supplementary BCF funding to clear the deficit, further funding would be required next year to be able to continue.  A Government Green Paper would be required for Adult Care Funding to produce a solution by 2019/20 otherwise there was a real possibility that some services would cease;

·       It was suggested that, in order to develop the STP, health colleagues had focussed on the issues presented at Lincoln County Hospital rather than all facilities in Lincolnshire but that CCGs were now considering how to develop existing hospitals to further support communities;

·       Community Nurses would also be a key element to the health care structure to provide patients with the ability to go home;

·       The BCF submission included two year funding for MOSAIC which would support adult care, children's services and public health commissioned services.  Strategic partners, including Carers First and the sensory impairment service, would also use MOSAIC;

·       Tablet technology was key to relieving pressure on the council and investment in the Airedale system was being investigated.  This system was created by the Airedale Hospital in partnership with Immedicare to provide a range of telemedicine technology (Skype like technology) services including live 'face-to-face' meetings, consultations and training.  Diagnostic images could also be transmitted in real time plus vital signs and/or video clips could be monitored and shared remotely resulting in patient data being captured for review without delay;

·       This technology had been trialled in America, Canada and Australia where patient assessment had increased from 30-40 patients per day to 70-80 patients per day.  The system had also been trialled in northern Scotland where GPs were required to fly or use boats to reach patients in remote areas therefore this system had been more efficient for both GP and patient;

·       The Committee was advised that they would be given an opportunity to speak with the Chairman of the provider organisation at its meeting in January 2018;

·       Nursing homes had indicated that they would be keen to use this type of technology and it was explained that LCC would purchase the equipment but the maintenance cost would be the responsibility of the NHS;

·       Airedale/Immedicare clinical staff would respond to any call initially whilst clinical staff locally were trained to a safe standard;

·       The biggest cost to the council was the implementation of MOSAIC and the purchase of the new equipment but it was stressed that the majority of these funds were non-recurrent;

·       The Committee intended to consider an item on the Housing, Health and Care Delivery Group, a sub-group of the Lincolnshire Health and Wellbeing Board, at the meeting in November 2017; and

·       In relation to recommendation 3(a) [Adult Social Care Needs], the Committee suggested that consideration be given to extending the list to include assessments due to the fact that assessments were driven by an IT platform.

 

At 11.25am, Councillor Mrs P A Bradwell left the meeting and did not return.

 

RESOLVED

 

          That the recommendations in the report to the Executive Councillor be supported by the Committee, and that any relevant comments be passed to the Executive Councillor for Adult Care, Health and Children's Services as part of her consideration of this item, including the above suggestion in relation to recommendation 3(a) [Adult Social Care Needs], that consideration be given to extending the list to include assessments due to the fact that assessments were driven by an IT platform.

Supporting documents:

 

 
 
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