Agenda item

This report provides the Health and Wellbeing Board with details of the Integration and Better Care Fund Plan for 2017-19 submitted on the 11^th September to NHS England.

Note:  The documents included in the Supplementary 2 Agenda are appendices to Appendix 1, the Better Care Plan 2017/19.

The report provided details of the Better Care Fund Plan for 2017/19 (BCF).  The government issued late guidance in July, setting a submission date of 11^th September, within a short timeframe.  This meant that much of the considerable collaborative work undertaken to prepare the plan had been undertaken before the meeting.  Councillor Coleman commended officers for the highly detailed and comprehensive report, which had been put together in a very short time period, developed through extensive dialogue and agreement with partner organisations.

Davey Thompson, Associate Director, BCF Lead, explained that this was the third BCF submitted in two years and had been amended to align with other local authorities and the CCG.  The number of schemes taken forward had been reduced to 7, after a number of previous schemes were now operating as business as usual. It was confirmed that collaboration throughout the process had been a key factor to facilitate formal signing off. 

Referring to section four, the Board noted progress built throughout 2016-17, translating the vision for integration into a strategy and delivery plan that was both assured and demonstrated confidence in the partnership between local authorities and CCGs.  Section five set out high level figures, indicating a jointly agreed budget of £43.708 million.  This included a minimum £5.782 million, to be transferred to Adult Social Care, in order to protect frontline services and to meet a condition of the BCF.

Keith Mallinson expressed concern about the provision of podiatry service being withdrawn from people with long term conditions such as diabetes.  Janet Cree explained that podiatry services did not form part of the service provision covered by the BCF.  Councillor Vaughan confirmed that this had been highlighted at the previous evening’s Health, Adult Social Care and Social Inclusion, Policy and Accountability (HASCSIPAC).  It was intended that that this be considered at its next meeting in November. 

Ian Lawry commented that the voluntary and community sector in Hammersmith and Fulham was broadly supportive and welcomed the BCF view on integration but felt this could go further and encompass the voluntary and community sector as a collective, ensuring a more devolved process of delivering care in the community.  He cited the examples of MIND and the White City Enterprise, recognising the need to consider the social determinants of ill-health. 

Commenting further, Keith Mallinson, highlighted further concerns regarding a lack of consultation, making the point that many viable projects were delivered short term, the result being a negative impact on recruitment and job security, with insufficient resources to meet need. Graham Terry responded that it was important that ASC continued to work closely with the CCG, delivering greater integrated care, and, help build more resilient and robust communities.  ASC was well positioned to be able to help individuals make the most of community assets, eventually reducing the cost to the service. Graham Terry agreed with the views expressed and supported a socially inclusive approach which would more proactively involve the voluntary sector.  Councillor Coleman acknowledged the work of White City Enterprise in building the links between individuals and groups in the locality which provided local community support, facilitating greater connections between them.  Councillor Coleman indicated that he supported the development of closer work with the voluntary sector.  Ian Lawry responded that he was keen to help support a more collective, community based approach.  He acknowledged that there had been progress but that he would like to see more integration of care in the community, not just with GP services, which would help alleviate pressure.

Janet Cree observed that the ‘real’ work would now commence now and that the Board would need to formally monitor the delivery of the BCF.  Davey Thomson added that a deep dive consideration of the schemes would be required, expected to be complete by December 2017 against national metrics.  A progress report to the Board could be prepared for its meeting in January 2018.

ACTION: BCF Progress update (January 2018) - All

Councillor Coleman thanked officers and partnership agencies for their contributions on what was a complex area of work, delivered within challenging circumstances.  Councillor Coleman stated that he would be formally writing to the Department for Health to raise his concerns regarding the issuing of delayed guidance within a short timetable. 

ACTION: Chair of the Board

RESOLVED

That the Health and Wellbeing Board endorse the Integration and Better Care Fund Plan for 2017-19.