To review the better care fund (BCF) year-end 2022-2023 report, as per the requirements of the programme.

Hayley Doyle (All Age Commissioning) provided an overview of the Better Care Fund year-end report 2022-23. The principal points included:

1.  There are three ambitions that are not on track to meet the planned performance by the end of the year:
   1. Avoidable admissions to hospital:

                                               i.     The planned performance at year-end was 1,106 against a metric of 605

                                              ii.     A programme of admission avoidance including virtual ward and urgent care programmes are being implemented currently and the development of an approach to integrated long-term conditions management is envisioned to help improve future performance.

                                               i.     This relates to the percentage of people who are discharged from acute hospitals to their normal place of residence.

                                              ii.     The metric was set at 91.6% but was not met with data showing a year-end total of 90%.

                                             iii.     There is a key lack of capacity within Herefordshire’s re-enablement and home care markets and the ability to discharge patients from acute beds to home, in a timely manner, has seen some patients being transferred to community hospital beds or to discharge to assessed beds in the community.

                                            iv.     This has been necessary in order to release acute bed capacity within the hospital, however, work is being done to improve in this position.

                                              v.     There has been further recruitment to vacancies within the home first team and the re-enablement service provided by Hoople and this position has increased at the latter end of 2022/23 with Hoople moving toward full recruitment across those service areas.

                                               i.     This relates to the proportion of older people who are still at home 91 days after discharge from hospital into re-enablement/rehabilitation services.

                                              ii.     The metrics show that Herefordshire failed to meet this target with a figure of 70.8% against a target of 80%.

                                             iii.     The CQC registered re-enablement service was transferred from Herefordshire Council to Hoople in June 2022 and there were some reporting issues due to staff changes at this time. This has impacted some of the data collection but have since been addressed.

                                            iv.     Reporting has improved in the remaining quarters in 2022/23 with the percentage of individuals remaining at home 91 days after leaving the service averaging around 78% for the latter quarters.

                                              v.     The issues in the recording in quarter 1 have impacted upon the overall year percentage. Therefore, there are some nuances around the accuracy of data which have been since corrected. Nevertheless, the re-enablement service are experiencing an increase in the complexity of patients being taken on by the service which has an impact on the results in this area.

                                            vi.     Work continues to be done as a local authority with Hoople to improve this position.

2. Overall, the Better Care Fund pools represent a significant increase in investment in core services and there are a number of areas where by end of year, the system can be successful in reaching planned ambitions and improving outcomes for people who receive services.
3. The Better Care Fund approach is  ...  view the full minutes text for item 20