Decision details

Cabinet considered a report which sought approval of the proposed plan for the Better Care Fund (BCF) covering the financial year 2019/20. 

The Better Care Fund Policy Framework for 2019/20 had been published on 10 April 2019 by the Department of Health and Social Care and the Ministry of Housing, Communities, and Local Government.  The BCF, which had been in operation since 2015/16, was a government initiative to improve the integration of health and care services, with an emphasis on keeping people well outside of hospital and facilitating discharge from hospital.

The BCF created a pooled fund, managed jointly by the Authority and NHS North Tyneside Clinical Commissioning Group (CCG). The total value of the fund was £27,547,883, an increase of 14.1% over 2018/19.

CCGs were required to contribute a defined amount to the fund, to support adult social care. The resulting income from the NHS was £10.5 million. Together with the “Improved Better Care Fund”, which was paid directly by Government to the Authority, the BCF supported 21% of adult social care revenue expenditure.

BCF income helped to fund the Authority’s community based social care services, such as reablement, immediate response home care, CareCall, and loan equipment/adaptations. It also contributed towards services to support carers, the Community Falls First Responder Service, and to independent living support for people with learning disabilities.

Government guidance for the BCF stated that 2019/20 was to be a year of minimal change for the BCF. The national conditions for the fund were unchanged. BCF plans were required to be signed off by Health and Wellbeing Boards (HWB), and the North Tyneside HWB had approved the BCF plan on 12 September 2019.

An allocation for winter pressures, which in 2018/19 had been paid direct to local authorities but not included in the BCF, was included in the BCF for 2019/20. In 2018/19 that money had been used to support short-term admissions to residential care (79% of the funds) and additional hours of home care support (21% of the funds). Both of these measures relieved pressure on the NHS by supporting discharge from hospital or avoiding admission to hospital.

The timetable for submitting a BCF plan was in advance of the timetable for agreeing a winter plan. Discussions with NHS and social care stakeholders had been organised by the Local Area Delivery Board (LADB) to progress a Winter Plan for 2019/20.

The BCF Partnership Board would take soundings from the LADB, to determine the most appropriate use of winter pressures funding to support the 2019/20 Winter Plan, as it was developed further.

The plan represented a natural progression from the 2017/18/19 plan, with some changes to take into account progress that had been made. Within the Future Care Programme, action was under way to further develop services for older people, which would lead to reconfiguration of some services included in the BCF, within the overall financial envelope set out in the BCF Plan.  An Integrated Community Frailty Service for North Tyneside would be created through the reconfiguration of Care Point, Care Plus, Day Hospital services, and the intermediate care beds at Howdon and Royal Quays.

Further details on each of the key elements of the Framework were set out in the report.

Cabinet considered the following decision options: to accept the recommendations set out in paragraph 1.2 of the report; or alternatively, not to approve the recommendationsand suggest an alternative approval mechanism to ensure that North Tyneside was able to meet the externally prescribed timetable for submission of the BCF plan to NHS England.

Resolved that (1) the arrangements and progress made to date in developing the Better Care Fund in North Tyneside be noted; and

(2) the Head of Health, Education, Care and Safeguarding, in consultation with the Chair of the Heald and Wellbeing Board, the Cabinet Member for Adult Social Care and the Cabinet Member for Finance and Resources, be authorised to approve the final Better Care Fund plan on behalf of the Authority for submission to the Department of Health.

(Reasons for decision: The continuation of the Better Care Fund presents an opportunity to take forward the principles of the Health and Wellbeing Strategy.  Delay in agreeing a plan for use of the Fund may lead to delays the release of funds by NHS England.)