Agenda item

(To receive an update report from Glen Garrod, Executive Director Adult Care and Community Wellbeing in relation to the Better Care Fund)

The Board gave consideration to a report from Glen Garrod, Executive Director of Adult Care and Community Wellbeing, which provided an update on Lincolnshire's plans for the Better Care Fund Narrative Plan and Planning Template for 2017/18 and 2018/19.

The Board was advised that there had been a number of changes by the Government, one was that CCGs and Upper Tier Councils needed to agree a joint plan to deliver the requirements of the BCF for 2017/18 and 2018/19 via the Health and Wellbeing Board.

It was reported that nationally an additional £105m was anticipated to be made available to Upper-Tier Councils through the BCF in 2017/18, and £825m in 2018/19. 

That would mean that the sums for Lincolnshire would be:-

·         2017/18 – a further £2.1m;

·         2018/19 – a further £12.1m; and

·         2019/20 – a further £10.9m, making the BCF £25.1m greater than in 2016/17.

It was noted that the sums were expected to come to the County Council via a Section 31, direct from Government.

The Committee noted that officers were busy working on the BCF submission for 7 January 2017, but this process was being hampered as guidance information had still not been received from the Government.  It was noted further that there was an informal consensus that Lincolnshire should make an application to be a pilot 'graduation site.'  It was noted further that this was the Government's latest phase for moving local areas from the BCF to the full integration of health and social care.  However, the benefits of being a 'graduation pilot' were still being determined nationally.

In conclusion, the Board was advised that there was a considerable amount of work to be undertaken to ensure that Lincolnshire was able to submit an agreed BCF Plan within the timescales.  

It was further reported that the eight Lincolnshire local authorities had developed and agreed an approach to managing and reforming the Disabled Facilities Grant (DFG) system in Lincolnshire over the two years of the 'new' BCF.  The outline agreement had been presented to the Joint Commissioning Board on 22 November, details of which were contained within Appendix B to the report presented.

Appendix A to the report provided the Board with details of the Better Care Fund Performance Report – Overview for Quarter 2.

A discussion ensued, from which the Board raised the following points:-

·         The Board were advised that DFG also applied to private housing; and that District Councils had the statutory responsibility for DFGs;

·         Some concern was expressed from the District representative to the target of eight weeks for a DFG to be completed from self-referral to job completion.  It was felt that this might not be achievable particularly in instances when planning permission was required.  A suggestion was made as to whether it would be more appropriate for this to be amended to being 85% complete within the timescale.  The Board noted that at the moment the document only had overarching officer agreement and had not been politically signed off by the Districts.  Therefore a formal agreement would still have to be considered through the decision making process as key decisions on implementation still had to be made;

·         Reference was made to a level of disappointment that the Chancellor's Speech had not made reference to health and social care.  However, it was noted that some dialogue was ongoing with the Government, and that there was some optimism that there might be added resource to social care;

·         A suggestion was made that Districts should look into using smaller contractors; as in some cases there was more flexibility locally and costs were lower; and

·         A suggestion was made for ensuring that a Memorandum of Understanding was established between the County Council, the four CCGs and the Districts.  Officers reassured the Board that a Memorandum of Understanding was already being drafted.

Councillor C R Oxby wished it to be noted that he had worked on DFG works for a local Carity Housing Association.

The Board was reminded that any delegation from the Lincolnshire Health and Wellbeing Board was dependent on the statutory signatories.

RESOLVED

1.    That delegation be given to the Executive Director of Adult Care and Community Wellbeing, in consultation with the Chairman of the Lincolnshire Health and Wellbeing Board, the responsibility to submit the BCF Plans for 2017/18 – 2018/19.

2.    That the Lincolnshire Health and Wellbeing Board notes that the Joint Commissioning Board is likely to recommend that the Protection of Adult Care Services should be at the minimum amount identified in Planning Guidance due to be issued after 12 December 2016, and that the Council are likely to accept this minimum amount (all subject to any material requirements in the national guidance).

3.    That the Lincolnshire Health and Wellbeing Board defers to the A & E Board target setting; and notes that 'stretch targets' will be set for both 2017/18 and 2018/19, notably with respect to Non-elective Admissions (NEA) and Delayed Transfers of Care (DTOC).

4.      That agreement be given to the Disabled Facilities Grant paper (detailed at Appendix B), prepared by the Interim Director of Public Health should provide a steer on the way forward to address DFGs for 2017/18 – 2018/19; but should take into account the comments raised with regard to amending the proposed target for completing DFGs from self-referral to job completion.

5.    That agreement be given to Lincolnshire making an application to be a pilot 'graduation site'.

6.    That agreement be given to not progressing any work in developing a contingency sum in the next BCF submission.  (Subject to any material requirements in the national guidance).