Agenda item

To receive a presentation on the Better Care Fund.(20 mins)

The Committee received a presentation on the implementation of the Better Care Fund from the Director of Health and Wellbeing.

During the discussion of this item the following points were made:

·         The Better Care Fund was not new money and was taken from existing Clinical Commissioning Group budgets and ring fenced for health and social care integration. 

·         It created a local single pooled budget to incentivise the NHS and local government to work more closely around people and care services.

·         The Fund was about moving away from a ‘sickness service’ and moving towards a focus on enabling people to live independently within the community.  It aimed to reduce demand on the acute sector and less avoidable admissions, faster discharge and reduced care home admissions.

·         Locally the Better Care Fund was £9.56million, of which £1.2million was added Council funding.  Councillor Miall questioned whether this was an annual amount and was informed that it was meant to be recurrent but was currently set at one year only.

·         There were 9 schemes in total, 4 of which were Wokingham schemes and 5 of which were being delivered across Berkshire West level.

·         Stuart Rowbotham outlined the 9 schemes:

Ø  01 Health and Social Care Hub (Berkshire West scheme) – a single point of access across health and social care.

Ø  02 Integrated Short Term Health and Social Care Team - teams were collocated at The Forge.

Ø  03 Step Up/Step Down Beds – accommodation for intense reablement support for a short period of time, 2/3 weeks.  2 pilot one bedroom flats in Alexandra Place were due to open shortly.  It was confirmed that support would be 24 hours.  

Ø  04 Domiciliary Plus – more intensive home care especially at night.

Ø  05 Hospital at Home Service (Berkshire West Scheme) – this was going through a reiteration.

Ø  06 Enhanced Care and Nursing Home Support (Berkshire West Scheme).

Ø  07 Connected Care (Berkshire West Scheme) – connected IT systems in health and social care.

Ø  08 Neighbourhood clusters, Primary prevention and Self-Care – congregating services into neighbourhood sized services based around GP clusters. 

Ø  09 Access to General Practice (Berkshire West Scheme) - enhanced services.

·         Each project had an implementation group which fed into the Wokingham Integration Strategic Partnership, which in turn reported to the Health and Wellbeing Board. 

·         The Department of Health regularly monitored the Plan.

·         The Fund was subject to various conditions which were outlined by Stuart Rowbotham.  It was noted that the element of the fund linked to non-elective admissions reduction target would be released into the pooled budget proportional to performance.  The Committee was informed that Wokingham had one of the lowest non elective levels in the country so the target would be difficult to achieve.  Members were assured that this element had not been allocated to any of the projects.

·         The Committee was informed that the Better Care Fund would mean improved health outcomes for residents, a focus on prevention and admission avoidance, more integrated, joined up services and potential reduced overall spending as shift from acute to community takes place.

·         In response to a question regarding the Step Up/Step Down Beds, Stuart Rowbotham indicated that people were not charged for using the service and that the costs associated with the Step Up/Step Down Beds were four times less than a hospital bed for the same period of time.

·         A Member questioned how long someone had to live in the Borough before they became the Council’s responsibility.  He was informed that this was dependent on the Ordinary Residents Regulations and if the individual’s move was intended to be permanent.

·         A member of the public asked whether additional staff had had to be employed to implement the schemes.  Stuart Rowbotham stated that some staff had been seconded or released from their day job.  Three consultants had also been employed.

·         Councillor Ray asked which of the 9 schemes were the highest priority and was informed that the Integrated Short Term Health and Social Care, Neighbourhood Clusters, Enhanced Domiciliary Care and Step Up/Step Down Beds, were.

·         Stuart Rowbotham explained the concept of the Neighbourhood Clusters.

·         Members were assured it was hoped that the Step Up/Step Down Beds would have 8 flats in total.  Councillor Gilder questioned whether the facilities at Woodley Age Concern could be used and was informed that it was important that the environment was right and that the Woodley Age Concern was a residential care home, not a home environment.

RESOLVED: That the presentation on the Better Care Fund be noted.