To review the better care fund (BCF) 2023/24 quarter two and quarter three reports, as per the requirements of the Better Care Fund (BCF) programme.

The Service Director All Age Commissioning presented the item. The principal points included:

1. The Quarter 2 report focuses on a summary of changes in demand and capacity plans and provides updates against metrics. The Quarter 3 report collects the information against the metrics and ambitions in addition to an update on spend.
2. As a system, a lot of work is being undertaken against all of the BCF schemes. The focus remains on supporting people at home to avoid hospital admissions or the need for longer-term care.
3. Over the last two quarters, significant movement has been seen in relation to homecare market with increased capacity, new entrants and new providers to that homecare framework. The waiting list has reduced to only seven people last week.
4. Increased acuity is being seen with a higher number of hours required for those coming through homecare.
5. Work has been ongoing across the system with ICB colleagues around discharge to assess services.
6. Discharge to Assess ‘sprint’ is a significant programme of work to address challenges overseen in Discharge to Assess services including a complete review of pathways such as working with hospital teams at point of discharge, occupational therapy teams, reablement offer, and pathways through the community access team service.
7. There has been an increased commissioning capacity to work closely with Hoople to make changes and work alongside Hoople and other ICS colleagues in the re-design of the service specification for both Home First and Hillside. That work continues and will be reporting into the Discharge to Assess Board from next week.
8. Issues continue with data recording when capturing an accurate picture for Discharge to Assess data. A data specialist is being appointed who will be hosted by Taurus.
9. Work has been close with Hoople and capacity in the Home First service will begin to increase following a number of changes and consultation with staff teams delivering the reablement service via Home First.
10. The BCF partnership group has been re-established and is meeting regularly and will report directly into the Integrated Care Executive and upwards to One Herefordshire Forum in relation to governance and performance monitoring going forward.

Adrian Griffiths (Business Partner) noted that the five pools which make up the BCF are very close to break-even running up to the end of December 2023. At the end of the summer, it is likely that the year-end report will be ready and this year’s refreshed plan.

The Service Director All Age Commissioning added that in terms of longer-term care for residential and nursing care, work is being done with the market to look at block book arrangements for longer-term residential and nursing care beds. There is capacity in the market to source longer-term care, but challenges remain around the affordability of that care.

The Chair asked at what stage is the decision made to determine what level of care a person requires.

The Vice-Chair responded that Discharge to Assess does not involve that decision-making in the hospital but rather at a later stage during support and  ...  view the full minutes text for item 60