To approve the council’s contribution to the Herefordshire better care fund (BCF) and Integration plan 2019-20 and the section 75 agreement from 1 April 2020 to 31 March 2025. In summary, the report identifies the following key points:

·         The better care fund (BCF) provides a mechanism for joint health, housing and social care planning and commissioning. It brings together ring-fenced budgets from Clinical Commissioning Group (CCG) allocations, and funding paid directly to local government, including the Disabled Facilities Grant (DFG), the improved Better Care Fund (iBCF) and the Winter Pressures grant;

·         The council’s contribution to the better care fund is £31.5m revenue and £2m capital for 2019/20;

·         It is a national requirement, set by NHS England, that the better care fund is transferred into one or more pooled funds established under section 75 of the NHS Act 2006; the four key national conditions and national metrics for the BCF remain consistent from 2018-19;

·         Herefordshire partners remain committed to working together to deliver a local system ‘where strong communities encourage individual citizens to live healthy lives and offer support when this is required for them to maintain their independence, with sustainable, aligned health and care services for local people’;

·         The council and CCG continue to work together to deliver on the key priorities within the plan to achieve service redesign and improve the delivery of service in order to achieve the priorities of the health and wellbeing strategy in the most cost effective way;

·         Herefordshire’s BCF and Integration plan 2019-20 details the local approach to integration, plans to achieve metrics and plans for ongoing implementation of the HICM for managing transfers of care. The plan maintains the key schemes identified in the 2017-18 submission; and

·         the plans are intended to move our health and social care system to a new service model in which patients get more options, better support and properly joined up care at the right time in the optimal care setting will support communities to remain within their own homes and reduce the need for hospitalisation and long-term care.

That:

(a)       the council’s contribution to the better care fund of £31.5m revenue and £2m capital for 2019/20 be approved;

(b)       approval be given for the council to enter into a section 75 agreement with Herefordshire clinical commissioning group (CCG) for up to 5 years, (1 April 2020 to 31 March 2025); and

(c)       the director for adults and communities and the director for childrens and families  be authorised, following consultation with the solicitor to the council and s151 officer, to take all operational decisions necessary to approve the scheme level detail within the budget approved by Cabinet in the s75 agreement on an annual basis to 31 March 2025.

1.         Cabinet could decline to approve the council's contribution. As per the national requirements, the plan was submitted to the national better care support team in line with the 27 September 2019 deadline. The health and wellbeing board approved the content of the better care fund and integration plan on 14 October 2019. If Cabinet were not to approve the council's contribution then the national BCF escalation process, as detailed within appendix two, would be implemented to support and ensure compliance. If a lesser contribution were to be approved the impact of this would be the same.

2.         Cabinet could decline to approve the section 75 agreement for the period 1 April 2020 to 31 March 2025. It is a national requirement, set by NHS England, that the better care fund is transferred into one or more pooled funds established under section 75 of the NHS Act 2006. The existing section 75 agreement (as agreed by Cabinet on 28 February 2019) is due to end 31 March 2020.

3.         Cabinet could approve the section 75 for a shorter period, however the benefit of entering into a 5-year agreement is that it will provide stability and ensure that a suitable section 75 agreement is consistently in place. Scheme level details would be updated on an annual basis.