Issue - meetings

The two year Better Care Fund Plan had been signed off last year so this report was just an update. New guidance would be produced for next year's plan. The outturn last year was a £1.3 million overspend after using nearly £200,000 of reserves. This overspend was largely due to the cost of funding care for people who had been discharged from the acute hospitals. The CCGs and County Council had covered the overspend from their base budgets.

There were a number of performance metrics set nationally. 4 out of 5 were still behind the target. They were within target for delayed transfers of care.

There had been 2 main variances from last year; firstly, the reduction of recovery beds in Wyre Forest and secondly, the step down unit in Worcester which allowed for faster discharge from hospital.

The forecast outturn for 2018/19 was expected to be £1.8 million largely due to discharge problems and the general pressure on acute services and the whole care system.

Comments made by attendees included:

·       It was queried whether the fact that the numbers of older people who were still at home 91 days after discharge from hospital were 5% lower than the target meant that people were being sent home too early and whether the issue should be scrutinised. It was confirmed that it was being looked at to see how it could be improved

·       The BCF was not just to reduce admissions to the acute sector and to facilitate discharge, it was used to help across the entire health and care system

·       The rate of permanent admissions to residential care was a national metric and a lower figure was better. If support was not available in the community the rate of admissions would rise

·       It was unclear if any work was being carried out to understand the flow of people from BME groups through emergency care but it felt it could be included in the capacity planning work which was currently underway

·       There was no formal agreement that the overspend would be split between the Council and the CCG but it was hoped that would be the case. There was also the possibility that that the amount received for the BCF could increase.

RESOLVED that the Health and Well-being Board

a)     Noted the financial outturn to the BCF for 2017/18;

b)    Noted the progress made towards the national targets for the BCF for 2017/18; and

c)     Noted the significant cost pressures on the BCF for 2018/19 due to the pressures arising from the urgent care system.