Report to:                  East Sussex Health and Wellbeing Board

Date:                           29th September 2022

By:                              Director of Adult Social Care and Health

Title:                           Better Care Fund Plans 2022/23

Purpose of Report:   To provide a summary of the Better Care Fund (BCF) requirements for 2022/23 and to seek approval of the East Sussex BCF plans.

Recommendations:

East Sussex Health and Wellbeing Board is recommended to:

1.    Note the requirements for 2022/23 Better Care Fund

2.    Approve the East Sussex Better Care Fund Plans for 2022/23

1       Background

1.1          Since 2014, the Better Care Fund (BCF) has provided a mechanism for joint health, housing and social care planning and commissioning, focusing on personalised, integrated approaches to health and care that support people to remain independent at home or to return to independence after an episode in hospital. It brings together ring-fenced budgets from Clinical Commissioning Group (CCG) allocations, and funding paid directly to Local Government, including the Disabled Facilities Grant (DFG) and the improved Better Care Fund (iBCF).

1.2          The continuation of national conditions and requirements of the BCF in recent years has provided opportunities for health and care partners to build on their plans to embed joint working and integrated care further. This includes working collaboratively to bring together funding streams and maximise the impact on outcomes for communities whilst sustaining vital community provision.

 

2       National BCF Planning Guidance and Requirements for 2022/23

2.1          The 2022/23 Planning Guidance was published on 19th July with local plans to be submitted by 26th September. 

2.2          The BCF Policy Framework and Planning Requirements were published on 19th July 2022 with plans due for submission on 26th September.

2.3          The Better Care Fund plans for 2022/23 include:

·         A completed planning template which confirms the expenditure plan meets the national conditions and the East Sussex ambitions to progress performance against the identified metrics.

·         A narrative plan outlining how the Better Care Fund is used in East Sussex to support local priorities including integration, hospital discharge, support for unpaid carers, collaboration with housing and addressing health inequalities.

·         A Capacity and demand template outlining the available capacity and predicted demand for intermediate care services for the remainder of 22/23 and the associated spend both from the BCF and from other funding streams.  Whilst submission of a completed template is required, it will not be part of the BCF assurance for 2022/23.

BCF National Conditions

2.4          National conditions 1-3 for the fund are broadly similar to 2021-22 and continue to require a minimum spend level on social care from the NHS Sussex (formerly CCG) minimum.

2.5          National condition 4 requires that local partners should have an agreed approach to implementing the two policy objectives for the BCF, set out in the Policy Framework:

I.          Enable people to stay well,

II.         Provide the right care in the right place at the right time.

2.6          This is outlined in the narrative plans and includes:

·         Our approach to integrating care to deliver better outcomes, including how collaborative commissioning will support this and how primary, intermediate, community and social care services are being delivered to support people to remain at home, or return home following an episode of inpatient hospital care.

·         How BCF funded services support delivery of the objectives.

·         Local implementation of the High Impact Change Model with identified actions.  

BCF Metrics

2.7          The length of stay metric is not part of requirements in 2022-23. However, it will remain a priority and the data will continue to be provided and monitored regionally and nationally.

2.8          The metrics included in the planning template for this year are:

Metric

Detail

Avoidable admissions

Unplanned Admissions for chronic ambulatory care sensitive conditions (NHS OF 2.3i)

Residential care admissions

Annual rate of older people whose long-term support needs are best met by admission to residential and nursing care homes. (ASCOF 2A part 2)

Effectiveness of reablement

People over 65 still at home 91 days after discharge from hospital with reablement (ASCOF 2B part 1)

Discharge destination

Percentage of discharges to a person’s usual place of residence (SUS data)

 

3       East Sussex Better Care Plans 22/23

3.1          Unlike previous years, the NHS minimum has risen by 5.66% uniformly across all Health and Wellbeing Boards (HWBs) and has been set out in the published allocations

3.2          Improved Better Care Fund (iBCF) and Disabled Facilities Grant (DFG) conditions remain broadly the same and have been issued to local authorities – iBCF has increased by 3% in all LAs.

3.3          Adult Social Care (ASC) contribution and NHS commissioned Out of Hours (OOH) ringfences to increase in line with the overall increase i.e., 5.66%.

3.4          Contributions to the Better Care Fund have been confirmed and agreed as:

Resources

Funding

Lead Org

Contribution (000)

East Sussex CCG

CCG Minimum Contribution

CCG

£46,960

ESCC- Carers

ESCC

ESCC

£694

ESCC - DFG

Disabled Facilities Grant

ESCC

£8,124

ESCC - IBCF

Improved Better Care Fund

ESCC

£21,777

Total Resources

 

 

£77,555

 

3.5          Whilst many of the schemes remain the same as previous years, some amendments are proposed for this year:

·         Healthy Hastings and Rother: whilst some HH&R schemes have been funded from BCF in previous years, it was recommended and agreed for all the remaining schemes to be funded via BCF in 22/23 whilst subject to review. This amounted to an additional commitment from BCF of £205k and the detailed breakdown of these schemes can be found on relevant tab of the schedule.  

·         Integrated Community Equipment Services (ICES): in addition to an annual uplift of £150k NHS contribution to the pooled fund, £250k has also been identified to ensure the service is resourced to fully support the system this year. ESCC contributions are funded outside of the BCF and the pooled budget functions on a 50/50 basis.

·         Hospital Discharge Programme: £576k unallocated funds have been aligned to support the Hospital Discharge Programme.

3.6          As with previous years the East Sussex BCF Plans for 2022/23 align with and support the delivery of wider transformation of the health and care system and the key priorities within the East Sussex Health and Social Care Plans

 

3.7          The previous Section 75 agreement which facilitates the pooling of the Better Care Fund in East Sussex will be updated for 2022/23 once these plans have been approved.  

3.8          Due to the Health & Wellbeing Board meeting after the submission date the plans were submitted with delegated authority, however, they will not receive final assurance until approval by the Health & Wellbeing Board has been confirmed.

4       Conclusion and reasons for recommendations

4.1          This paper summarises the Better Care Fund requirements for this year and sets out the East Sussex plans confirming their alignment with national requirements and delivery of the wider transformation of the health and care system locally.

4.2          The Health and Wellbeing Board is recommended to:

1) Note the requirements for 2022/23 Better Care Fund

2) Approve the East Sussex Better Care Fund Plans for 2022/23

 

MARK STAINTON

Director of Adult Social Care and Health

 

Contact Officer

Sally Reed, Joint Commissioning Manager

Email: sally.reed@eastsussex.gov.uk

Tel: 01273 481912

 

Appendix 1: East Sussex HWB Better Care Fund Narrative Plan 2022-23

 

Appendix 2: East Sussex HWB BCF 2022-23 Planning Template

 

Appendix 3: East Sussex HWB Capacity and Demand Template