Agenda item

7.1       The Board considered a report on the Better Care Fund (BCF) plans for 2024/25. Mark Stainton introduced the report which sets out the plans for year 2 of the BCF funding. The grant conditions remain unaltered and there have been a few minor changes to the funding which are set out in the report and in more detail in Appendix 1 of the report which contains the financial template. Appendix 2 contains the BCF narrative report which covers the two-year period of the funding. The Board is asked to approve the BCF plans for 2024/25.

7.2       The Chair commented that the report provided evidence that longer-term funding works and that future longer-term funding from Government would be welcomed as this aids the surety and planning of services.

7.3       Ashley Scarff, Director of Joint Commissioning and ICT Development (East Sussex), NHS Sussex commented that the BCF template in Appendix 1 is an NHS England format which works well electronically but some sections can appear small in the printed format. He outlined that the work around demand and capacity planning continues throughout the year to aid modelling and ensure the Plan remains robust. The Discharge Fund element of the Plan will continue to evolve throughout the year, particularly the development of schemes for the winter period.

7.4       Stephen Lightfoot commented that he would like to put on record that NHS Sussex is grateful for the way East Sussex County Council (ESCC) colleagues have collaborated on the BCF. He stated that there are a really good set of initiatives in the Plan and agreed that longer-term funding enables better outcomes to be achieved. He outlined that the NHS Sussex contribution to the BCF is £57.5 million which has been increased by 6% compared with an overall increase of NHS budgets of 1%. This represents an investment in this activity and ensuring that the expenditure has an impact is important. Section 3.8 of the report sets out the four key measures that are mandated to monitor the delivery of the Plan, but it will also be important to look at more local measures, such as those around high intensity services users, carer support and urgent community care response.

7.5       Stephen Lightfoot added that in terms of impact, discharge is an important part of the activity delivered by the BCF funding. For example, in East Sussex Healthcare Trust (ESHT) hospitals the number medically fit to discharge patients as of 30 June 2022 was 115. This rose to 177 as of 30 June 2023 and then to 232 as of 30 June 2024, which represents a 29% increase and reduces the number of beds available. It will be important to use some of the BCF funding investment to reduce the number of patients ready and waiting for discharge from hospital. Going forward it will be important for the partners to achieve as much impact as possible from the BCF funding.

7.6       Mark Stainton agreed with the point made around measures and that it will be important to develop further measures, in addition to the four mandated measures, for the £94 million worth of expenditure. Some measures, such as those around the Disabled Facilities Grant, are reported in other places. ESCC, NHS Sussex and the NHS Trusts also carry out performance monitoring on a regular basis, some of which reflects the activity funded by the BCF. This could be drawn together to produce outturn monitoring information. There has been some very good joint working on discharge, with money ringfenced for discharge schemes across the Sussex health and care system.

7.7       Mark Stainton outlined that there are increasingly high levels of demand being experienced by the health and care system. In East Sussex the demography means that 26% of the population are over 65 years old, which is double the national average, and there has been an increase in the number of people over 85 years old. ESCC works well with ESHT and other partners to facilitate the timely discharge of patients and nobody waits for funding from Adult Social Care to get out of hospital. The position is complex with a number of reasons behind delayed discharges from hospital. Everyone in the system has a role to play in the collaborative work to tackle delayed discharges and only a small proportion in East Sussex are due to people waiting for social care.

7.8       The Chair commented on how much progress there has been in this area of work over the years and the local health and care system partnership is probably as advanced is it could be. Amy Galea, commented on the amount of learning that has taken place as a system, and the work of the transfer of care hubs has been reviewed recently. All partners have an understanding at a patient level of what is required and what needs to be done to support patient flow through the system.

7.9       The Board RESOLVED to:

1) Note the Better Care Fund requirements for 2024-25; and

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.