Agenda item

To seek approval of the Better Care Fund Plan for 2022/23 and to enter into a partnership agreement under Section 75 of the National Service Act 2006 (“a section 75 Agreement”) following consultation.

Cabinet received a report seeking approval of the Better Care Fund Plan for 2022/23 and 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 (a section 75 Agreement).

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 the North East and North Cumbria Integrated Care Board (the ICB). The value of contributions to the fund in 2022/23 was £30,774,007 which was an increase of 4.47% over 2021/22 BCF pooled fund.

ICBs were required to contribute a defined amount to the fund to support adult social care. The resulting income from the NHS was £12,310,605. Together with the “Improved Better Care Fund” grant, which was paid direct by Government to the Authority, the BCF supported 20.5% 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.

The detailed operations of the BCF in North Tyneside were set out in a nationally prescribed Planning Template and narrative plan which had to be approved by the local Health and Wellbeing Board before submission to NHS England by 26 September 2022. The plan would then go through an assurance process and once approved, a Section 75 Agreement would be prepared, between the North-East and North Cumbria Integrated Care Board (the ICB). That Agreement established a BCF Partnership Board with representatives from the Authority and the ICB.

The minimum value of the North Tyneside Better Care Fund was set nationally.  Table one 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 ICB to adult social care, and minimum spend on NHS-commissioned out of hospital services.

The North Tyneside Better Care Fund Narrative Plan was appended to the report at Appendix 1.  The North Tyneside Better Care Fund Planning Template was also included at Appendix 2.

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 work together, as equal partners, with shared objectives.

The BCF plan had enabled 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 20.5% of adult social care revenue expenditure, therefore it would not be possible to maintain the current level of services without the benefit of the Better Care Fund income.

Cabinet considered the following decision options: to accept the recommendations set out in paragraph 1.2 of the report; or alternatively, to not accept the recommendations and propose alternative approval mechanism.

Resolved that (1) the Better Care Fund Plan for submission to the Health and Wellbeing Board for further approval prior to submission to NHS England be approved; and

(2)the Director of Children and Adults Services, in consultation with the Director of Resources, the Director of Commissioning and Asset Management, and the Assistant Chief Executive, 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 submit a BCF Plan by 26 September 2022 and enter into a Section 75 Agreement is not met by 31 December 2022 the release of funds by NHS England could be delayed.)