Agenda item

Joint Report of the Associate Director of Commissioning (Care and Health) Devon County Council and NHS Devon CCG on the Better Care Fund (BCF), Quarter Return, Performance Report and Performance Summary on the BCF.

The Board considered a joint Report from the Associate Director of Commissioning (Care and Health) and NHS Devon Clinical Commissioning Group (CCG) on the Better Care Fund (BCF), Quarter Return, Performance Report and Performance Summary. The BCF was the only mandatory policy to facilitate integration between Health and Social Care, providing a framework for joint planning and commissioning. It brought together ring-fenced budgets from Clinical Commissioning Group (CCG) allocations, the Disabled Facilities Grant and funding paid to Local Government for adult social care services. The Health and Wellbeing Board had oversight of the BCF and was accountable for its delivery.

Regular reports were provided on the progress of the Devon Better Care Fund Plan to enable monitoring by the Health and Wellbeing Board. Performance and progress was reviewed monthly by the Joint Coordinating Commissioning Group through the high level metrics reports and progress overview.

In December 2020 the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government published the Better Care Fund Policy Statement 2020 to 2021, which had been delayed from March due to the pandemic. The statement set out the requirements for 2020/21 including no requirement to submit a BCF plan for this year. However, the following conditions must be met:

• Agree the use of mandatory minimum funding and place this in a pooled arrangement by an agreement under s.75 of the NHS Act 2006, with an appropriate governance structure which reported to the Health and Wellbeing Board.

• The contribution to social care from the CCG via the BCF was agreed and met or exceeded the minimum expectation 

• Spend on CCG commissioned out of hospital services met or exceeded the minimum ringfence.

• CCGs and local authorities confirm compliance with the above conditions to their Health and Wellbeing Boards.

The Report highlighted that national reporting of Delayed Transfers of Care (DToC) was suspended from the 19 March 2020 and instead, providers were expected to provide daily data through the Strategic Data Collection Service (SDS).  DToC performance was greatly affected by COVID-19.  Delayed transfers started to decrease in March due to the requirement to reduce bed occupancy levels to 50% as part of the pandemic response, dropping to a very low level in April and May. In the period May to September delays increased steadily as elective services recommenced.

In addition, the Report highlighted that fewer older people were placed in residential/nursing care relative to population than comparator and national averages. However, there was an upward trend in permanent admissions to the end of March 2020.  Also, the percentage of people still at home 91 days after hospital discharge into rehabilitation / reablement services had declined significantlyto 72.9% at the end of Quarter 2 (September 2020), due to the pandemic. This was as a result of:

• a reduction in the take up of the service offer, for example with people self-isolating,
• changes to the recording of hospital discharges due to the Discharge to Assess guidance,
• some staff self-isolating meaning the service had to be reduced; and
• some staff had been redeployed to other services supporting people to remain in their own homes such as rapid response.

In respect of the total number of specific acute non-elective spells per 100,000 population, these were emergency admissions and whilst some were essential, the aim was to reduce the number of avoidable emergency admissions by targeting the preventative support services to the most vulnerable - in order to avoid an unplanned or emergency admission.

RESOLVED that the Board note thenational requirements and latest performance data.