Report to:                  East Sussex Health and Wellbeing Board

Date:                           27 June 2023

By:                              Director of Adult Social Care and Health

Title:                           Better Care Fund Plans 2023-25

Purpose of Report:   To provide a summary of the Better Care Fund (BCF) requirements for 2023 - 2025 and to seek approval of the East Sussex BCF plans.


East Sussex Health and Wellbeing Board is recommended to:

1.    Note the Better Care Fund requirements for 2023-25

2.    Approve the East Sussex Better Care Fund Plans for 2023-25 recognising the 2024/25 plans are subject to review later this year.


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 NHS Integrated Care Board (ICB) allocations, and funding paid directly to Local Government, including the Disabled Facilities Grant (DFG) and the improved Better Care Fund (iBCF).

1.2      For the next two years, the Additional Discharge Funding to enhance community and social care capacity is also required to be included in the BCF pooled budget arrangements.

1.3      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 2023-25

2.1      The BCF Policy Framework and Planning Requirements for the next 2 years were published on 5th April with local plans to be submitted by 28th June. 

2.2      The Better Care Fund plans for 2023/25 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 (Appendix 2). This template also includes local capacity and demand modelling outlining the available capacity and predicted demand for intermediate care services for the remainder of 2023/24.  

·         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 equality and health inequalities (Appendix 1). The narrative also outlines lessons learnt from 2022/23 and how these have influenced the BCF Plans for 2023-25 and shaped the ambitions to deliver the BCF priorities and metrics.

·         Areas are asked to demonstrate how the additional Discharge funding is intended to provide increased investment in social care and community capacity to support discharge and free up beds.


2.3      BCF National Conditions:

The national conditions for the fund are broadly like 2022-23 and continue to require a minimum spend level on social care and community health services.


  1. Plans to be jointly agreed.
  2. Enabling people to stay well, safe and independent at home for longer.
  3. Provide the right care in the right place at the right time.
  4. Maintaining NHS’s contribution to adult social care and investment in NHS commissioned out of hospital services.

2.4      BCF Metrics:

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



Avoidable admissions

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

Falls Admissions

Emergency hospital admissions due to falls in people over 65

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)


The BCF Planning guidance advises of new metrics to be introduced in later this year and next year.

Expected in Q3 2023/24

Discharge metric

New for 2024/25

Proportion of people discharged who are still at home after 91 days


Outcomes following short-term support to maximise independence.


3       East Sussex Better Care Plans 2023-25

3.1      The vision for the BCF over 2023-25 is to support people to live healthy, independent, and dignified lives, through joining up health, social care, and housing services seamlessly around the person. This vision is underpinned by the two core BCF objectives:

·         Enable people to stay well, safe and independent at home for longer.

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

3.2      As with previous years the East Sussex Better Care Fund plan is developed and delivered within the context set by the:

·         Healthy lives, healthy people: East Sussex Health and Wellbeing Board Strategy 2022-2027

Healthy lives, healthy people: East Sussex Health and Wellbeing Board Strategy | East Sussex County Council

·         Improving Lives Together: Our ambition for a healthier future in Sussex - built upon the Health and Wellbeing Strategies of the three Sussex ‘places’:

·         Improving Lives Together: Sussex Integrated Care Board Shared Delivery Plan – five-year shared Delivery Plan including specific East Sussex ambitions and actions.

3.3      The NHS minimum contribution for has risen by 5.66% for 2023/24 with the same rise mandated for 2024/25.

3.4      Additional Discharge funding for 2023/24 has been allocated to Local Authorities (LAs) and the ICB to be included in the BCF. For 2024/25, Better Care Fund Plans should assume LA Discharge funding will increase by 66%. The ICB is required to agree with local Health and Wellbeing Boards how the ICB element of Discharge funding will be allocated at HWB level rather than being set as part of overall BCF allocations, this being based on allocations proportionate to local area need.

3.5      Improved Better Care Fund (iBCF) and Disabled Facilities Grant (DFG) conditions remain as previous years and the allocations for each remain at the 2022/23 rate for both years of these plans.

3.6      Adult Social Care contribution and NHS commissioned out of Hospital services ringfences have increased in line with the overall increase i.e., 5.66%

3.7      Contributions to the Better Care Fund for the next 2 years have been confirmed and agreed as:




Funding Source



Lead Org





NHS Minimum Contribution

NHS Sussex ICB







Disabled Facilities Grant




Improved Better Care Fund




Discharge Funding





Discharge Funding


NHS Sussex ICB



Total BCF Resources





3.8      The BCF funded schemes, having been reviewed to ensure they are aligned with plans for East Sussex and the local population, are carried forward from the previous year with the following additions:

·         Discharge Fund: LA Grant and ICB Allocation. The schemes funded by the Discharge Fund fall fully within the BCF plan following the initial roll-out in Q4 2022/23.

·         For 2023/24, the ICB will fund additional hospital discharge schemes via the BCF.

3.9      The previous Section 75 agreement which facilitates the pooling of the Better Care Fund in East Sussex will be updated for 2023/25 once these plans have been approved.  

3.10    Following submission, regional and national assurance processes will be undertaken with final assurance expected on 8th September 2023.

3.11    It is recognised that areas may wish to amend plans for 2024-25, following sign off and assurance, to:

·         modify or decommission schemes.

·         increase investment or include new schemes.

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 the national conditions and delivery of the wider transformation of the health and care system locally.

4.2      The Health and Wellbeing Board is asked to:  

  1. Note the Better Care Fund requirements for 2023-25.
  2. Approve the East Sussex Better Care Fund Plans for 2023-25 recognising the 2024/25 plans are subject to review later this year.




Director of Adult Social Care and Health


Contact Officer

Sally Reed, Joint Commissioning Manager


Tel: 01273 481912


Appendix 1: East Sussex HWB Better Care Fund Narrative Plan 2023-2025


Appendix 2: East Sussex HWB Better Care Fund Planning Template 2023-2025