Agenda item

To seek authorisation for the Director of Children and Adults Services, in consultation with relevant Director(s) of Service, to enter into an Agreement under section 75 of the National Health Service Act 2006 and to implement the financial and administrative arrangements for the Better Care Fund.

Cabinet considered a report seeking authorisation for the Director of Children and Adults Services to enter into a partnership agreement under section 75 of the National Health Service Act 2006 and to implement the financial and administrative arrangements for the Better Care Fund, following appropriate consultation.

The Better Care Fund (BCF), had been in operation since 2015/16, and 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 £29,457,097, which was an increase of 3.8% over 2020/21 BCF pooled fund.  CCGs were required to contribute a defined amount to the fund to support adult social care. The resulting income from the NHS was £11,651,150.  Together with the “Improved Better Care Fund”, which was paid direct by Government to the Authority, the BCF supported 21% of adult social care revenue expenditure within the Borough.

BCF income helped to fund community based social care services, such as

reablement, immediate response home care, CareCall, and loan equipment/adaptations. It also contributed towards the Authority’s services offered to support carers, the Community Falls First Responder Service, and to independent living support for people with learning disabilities.

In terms of Governance arrangements, the detailed operations of the BCF in North Tyneside were set out in a Section 75 Agreement, which was renewed each year, between North Tyneside Council and NHS North Tyneside CCG following submission of the BCF Plan. That Agreement established a BCF Partnership Board with representatives from the Authority and NHS North Tyneside CCG.

As requested by the Health and Wellbeing Board, who approved the BCF Plan on 11 November 2021 prior to its submission to NHS England, regular reports on the operation and performance of the BCF were provided to the Adult Social Care, Health and Wellbeing Sub-Committee of the Overview and Scrutiny Committee and this would continue to be the case. 

The BCF Policy Framework required that the BCF Plan be agreed by the Governing Body of the CCG as well as the Health and Wellbeing Board.  Such approval was given by the CCG on 23 November 2021. The Elected Mayor had approved the BCF Plan, prior to its submission to NHS England on 16 November 2021.

The minimum value of the North Tyneside BCF was set nationally. Table 1 in the report showed the value in the current year, and changes from previous years. The national framework also stipulated minimum contributions to be paid by the CCG to adult social care, and on NHS-commissioned out of hospital services

The Better Care Fund continued to play a key role in integrating health, social care and housing. The fund provided the governance and a context in which the NHS and local authorities worked together, as equal partners, with shared objectives.

The BCF plan had enabled the Authority to have a single, local plan for the integration of health and social care which had improved joint working and had a positive impact on integration. This had helped to relieve pressure on the health care system, with system performance in the North East remaining relatively strong against a difficult picture nationally.  The BCF accounted for 21% of adult social care revenue expenditure. Hence, the Authority would be unable to maintain the current level of services without the benefit of the Better Care Fund income.

Cabinet considered the following decision options:

Option 1:  Authorise the Director of Children and Adults Services, in consultation with the Director of Resources, the Director of Commissioning and Asset Management, and the Director of Law and Governance, to enter into an Agreement under section 75 of the National Health Service Act 2006 and to implement the financial and administrative arrangements for the Better Care Fund.

Option 2: Not agree to Option 1 and to suggest an alternative approval mechanism to ensure that an Agreement under section 75 of the National Health Service Act 2006 was entered into before 22 January 2022.

Resolved that (1) the Director of Children and Adults Services, in consultation with the Director of Resources, the Director of Commissioning and Asset Management, and the Director of Law and Governance, be authorised to enter into an Agreement under Section 75 of the National Health Service Act 2006 and to implement the financial and administrative arrangements for the Better Care Fund.

(Reason for decision:The continuation of the Better Care Fund presents an opportunity to take forward the principles of the Health and Wellbeing Strategy.  If the requirement to enter into a Section 75 Agreement is not met by 22 January 2022 the release of funds by NHS England will be delayed.)