Report to:                  East Sussex Health and Wellbeing Board (HWB)

Date:                           16th July 2024  

By:                              Director of Adult Social Care and Health

Title:                           Better Care Fund Plans 2024-25

Purpose of Report:   To provide a summary of the Better Care Fund (BCF) requirements for 2024 - 2025 and to seek approval of the East Sussex BCF plans.

Recommendations:

The East Sussex Health and Wellbeing Board is recommended to:

1.    Note the Better Care Fund requirements for 2024-25.

2.    Approve the East Sussex Better Care Fund Plans for 2024-25 recognising these represent an update on 2023-25 plans approved by the Board in June 2023. 

 

 


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      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.

1.3      Since last year, the Additional Discharge Funding to enhance community and social care capacity is also required to be included in the BCF pooled budget arrangements.

1.4      Following approval by the Board in June 2023, East Sussex’s two-year BCF plans were nationally assured and approved for 2023-25. A copy of the East Sussex HWB Better Care Fund Narrative Plan 2023-2025 is contained in appendix 2 of the report.

 

2       National BCF Planning Guidance and Requirements for 2024-25

2.1      The Addendum to the BCF 2023-25 Policy Framework was published on 28th March 2024. This provided a refreshed planning template to update on income, expenditure, setting outputs and new metric targets, capacity, and demand planning for 2024-25 alongside updated narrative to provide assurance of meeting the national conditions for the year ahead. A copy of the Better Care Fund 2024-25 update template is contained in appendix 1 of the report.

2.2      The Addendum also confirms the overarching approach to, and the funding conditions for the Discharge Fund for 2024 to 2025 to which expenditure is to be outlined within the plan and monitored quarterly.

2.3      Further information relating to the Addendum can be found on the external web link below.

Addendum to the 2023 to 2025 Better Care Fund policy framework and planning requirements - GOV.UK (www.gov.uk)

 

3       East Sussex updated Better Care Plans 2024-25

3.1      The contributions to the BCF Pooled budget for 2024-25 are outlined below.

Funding Source

 

 

Lead Org

2024/25

Contributions

NHS Minimum Contribution

NHS Sussex ICB

£52,426,847

Carers

ESCC

£694,000

Disabled Facilities Grant

ESCC

£8,860,833

Improved Better Care Fund

ESCC

£21,776,611

Discharge Funding

 

ESCC

£5,088,412

Discharge Funding

 

NHS Sussex ICB

£5,024,117

Total BCF Resources

 

     £93,870,820           

 

3.2      The NHS minimum contribution has risen by 5.66% for 2024/25 as in previous years.

3.3      The additional Discharge funding for 2024-25 has been allocated to Local Authorities (LAs) and the ICB to be included in the BCF.  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.

3.4      Improved Better Care Fund (iBCF) and Disabled Facilities Grant (DFG) conditions remain as previous years and the allocations for 2024-25 remain at the 2023-24 rate for these plans.

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

3.6      Many of the schemes and services previously funded through the Better Care Fund have continued into this year.

3.7      Modelling of the Capacity and Demand on community services to support avoidance of admission to and reduction in length of stay in bedded care have been reviewed for 2024-25. It is anticipated a further review of this will be required in October.

3.8      Metrics targets for 2024-25 have been reviewed for the following measures:

Metric

Detail

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)

Discharge destination

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

 

        There is one measure which is has been removed from BCF reporting for 2024-25.

Effectiveness of reablement

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

 

4       Assurance Timetable

4.1  Following submission of our plans on 10th June and pending approval by the Board, a proportionate regional assurance process is being undertaken to approve updates to plans for 2024 to 2025.

Assurance milestone

Date

Scrutiny of BCF plans by regional assurers, assurance panel meetings and regional moderation

10 June 2024 to 15 July 2024

Regionally moderated assurance outcomes sent to BCF team

15 July 2024

Cross-regional calibration

Mid-July 2024 (date to be confirmed)

Commence issuing of approvals letters giving formal permission to spend (NHS minimum)

31 July 2024

All section 75 agreements to be signed and in place

30 September 2024

 

5       Conclusion and reasons for recommendations

5.1      This paper summarises the Better Care Fund requirements for this year and sets out the East Sussex revised plans for 2024-25 (appendix 1) confirming their alignment with the national conditions. 

5.2      The Health and Wellbeing Board is asked to:  

  1. Note the Better Care Fund requirements for 2024-25.
  2. Approve the East Sussex Better Care Fund Plans for 2024-25 recognising these represent an update on 2023-25 plans approved by the Board in June 2023.

 

 

MARK STAINTON

Director of Adult Social Care and Health

East Sussex County Council

 

Contact Officer

Sally Reed, Joint Commissioning Manager

Email: sally.reed@eastsussex.gov.uk

Tel: 01273 481912

 

 

Appendix 1: East Sussex HWB Better Care Fund Planning Template 2024-2025.

Appendix 2: East Sussex HWB Better Care Fund Narrative Plan 2023-2025.