Agenda item

[To receive a progress report on the development and progress of the Better Care Fund including progress with:

i) Dementia; and

ii) Mental Health]

                                                                               [Steven Marshall and Viv Griffin]

Steven Marshall, Director of Strategy and Transformation, Wolverhampton City Clinical Commissioning Group presented a report on the development and progress of the Better Care Fund including progress with the Dementia and Mental Health Workstreams and the outline plans for 2016/17. He reminded the Board that the Better Care Fund programme was delivering system wide changes with the aim of delivering the following six outcomes:

·         Reduced Delayed Transfer of Care (“DTOC”);

·         Reduction in avoidable emergency admissions;

·         Reduced admissions to residential and nursing homes;

·         Ensured effectiveness of reablement;

·         Improvement patient/service user experience;

·         Improved dementia diagnosis rates.

He advised that “DTOC” remained a key issue to be delivered but that difficulties were still being encountered in achieving the target. A tri-partite agreement had been established between the Council, Clinical Commissioning Group and the Acute Trust to address this matter. With regard to the reduction in emergency admissions he advised that there had been an increase but this was due to the method of calculation with episodes of care and emergency admissions having conflicting numbers. There was , however, a requirement to report against the MAR (hospital data). He explained that the number of emergency admissions had actually reduced. In relation to the reduced admission to residential and nursing homes target, he reported that the figures had reduced and that Wolverhampton was one of the best performing areas in the country.

He reported that with the exception of the “DTOC” progress in achieving the targets was positive. He drew to the attention of the Board the establishment of the Community Neighbourhood Team (CNT) model. This model would see the establishment of three CNT’s wrapped around small numbers of GP practices. He outlined the composition of the core teams which would include District Nurses and Social Workers.

He drew to the attention of the Board the current financial position together with the current projected overspend. With regard to the 2016/17 financial year, he explained that the final guidance was still awaited and the timetable for sign off of the Delivery Plan which necessitated a requirement for delegated authority to be granted in order to meet the time frame.

The Chief Executive of the Royal Wolverhampton NHS Trust commented on the emergency admissions target and advised that attendance at the A&E Centre had broken records three times in as many weeks and that this presented an issue with 19 patients waiting in corridors on the previous evening. For the first time in his NHS experience however, bed availability had not been a problem. With regard to “DTOC” he reported that the position had improved enormously in Wolverhampton in recent times. The Strategic Director – People commented that the Council, the Acute Trust and the WCCCG continued to work together to address this problem but that maintaining people at home did have financial implications.

Jeremy Vanes, Chair of the Royal Wolverhampton NHS Trust enquired whether the Better Care Fund programme would be continued beyond 2018/19. The Director of Strategy and Transformation responded that there was an assumption, at national level, that Health and Social Care would be integrated more by 2020 and that the Better Care Fund would continue but would require more than joint commissioning.

Resolved:

1.    That the progress report on the current year’s activity be noted.

2.    That the intention to advise the Health and Wellbeing Board of the intention to establish a Section 75 agreement between City of Wolverhampton Council (CWC) and the Wolverhampton CCG for the purposes of delivering the Better Care Fund in the business year 2016/17, and process for developing this agreement, along with the progress to date be endorsed.

3.    That the draft Section 75 agreement be taken to the CCG governing body meeting on the 8 March and to the CWC Cabinet meeting scheduled for 23 March 2016 for final approval by both partner organisations.

4.    That the process for developing the 16/17 delivery plan, the progress to date be noted, and that the final approval of the 16/17 BCF delivery plan be delegated to the Chair of the Health and Wellbeing Board, Cllr Samuels and Cllr Mattu with advice from the Transformation Director CCG (Steven Marshall), and BCF Lead for the CWC (Viv Griffin) during March 2016.