To receive a report on the Better Care Fund Plan.

A report on the Better Care Fund (BCF) was noted.  The Director of Adults Wellbeing highlighted the following areas:

That in order to secure the necessary transformational change, agreed areas between the Herefordshire CCG (HCCG) and the Council would be focused upon.   These were outlined in Appendix One of the report.

The BCF had been submitted in line with national guidance and timescales but some key areas still required agreement. The minimum fund had been agreed, as had the target percentage for reduction in hospital admissions. Outstanding areas that required agreement were the Protection of Adult Social Care, Risk Sharing, Section 75 monies and the detailed implementation plan

A Ten Week Implementation Plan was in place to ensure that the areas not yet agreed were progressed. 

The outcome of the national assurance process was due to be announced by the end of October 2014, with four possible outcomes.  These were No Assurance, Assurance with Conditions, Assurance with Support or Assured

It is likely that Herefordshire would either be in the Assurance with conditions or Assurance with Support categories.

In the ensuing discussion, the following points were raised:

·         That the Health and Wellbeing Board might be expected to assume responsibility for the BCF monies, but it was not yet clear where the responsibility for performance management would lie.  It was possible that the Board could also be in charge of this.

·         That change to the guidance included a new assurance process and target reduction of 3.5% in emergency admissions.  Latitude had been included in this, as it had been felt that such changes would place undue pressures on the health system nationally.

·         That there was a specific function for the Health and Wellbeing Board to oversee the implementation of the BCF, and that this would give the Board a strong role in moving toward a prevention agenda.

·         There was a move to empower service users and the importance of personal budgets would increase not only in social care, but also in the NHS as people with complex health needs would be offered them. 

·         That whilst the BCF work predated the Transformational Board, it was one of the agents of change that the Board would be using. The BCF was changing what was happening in health and social care, and was allowing partner agencies to engage with finding alternative ways forward. 

Resolved: 

That;

a)      The summary of the revised guidance be noted;

b)     The elements of the plan agreed using the delegated powers agreed by the Health and Wellbeing Board subject to the completion of the ongoing work as required in the guidance and submission be approved;

c)      the task and finish approach for completion of further requirements and agreements be approved;

d)     the national assurance process and feedback to date was noted;

e)      authority be delegated to the Chair of the Health and Wellbeing Board, the Chief Accountable Officer of the CCG and the Director of Adults and Wellbeing as appropriate to agree further BCF plan submissions if required in November or December 2014.