Better Care Fund

John Webster – Director of CommissioningChris Badger – Assistant Director – Health and

Social Care Integration

Recap - What is the Better Care Fund?

“The Better Care Fund is a single pooled budget to support health and social care services to work more closely together in local areas.”

“It provided an opportunity to transform local services so that people are provided with better integrated care and support.”

“The Fund will support the aim of providing people with the right care, in the right place, at the right time, including through a significant expansion of care in community settings.”

NHS Planning Guidance, December 2013

Make up of fund nationally 2015/2016 (billions)

1.9

1.1

0.130.3

0.354 NHS Funding

Existing NHS monies al-located to social care

Carers Breaks

Reablement funding

Capital funding (incl. DFG)

£200m of this is new monies allo-cated in 2014/15, paid on condition of BCF being jointly agreed N.B. this is minimum that

can be pooled

National ENCCG HVCCG C and P CCG TOTAL

BCF contribution to social care from

NHS 2014/15£1.1bn £9.06m £9.59m £0.30m £18.95m

(of which new monies in 2014/15)

£200m £1.99m £2.10m 0.06m £4.15m

Existing NHS funds* £2.68bn £22.36 £23.58m £0.72m £46.66m

Total 2015/16 £3.8bn £31.43m £33.16m £1.02m £65.61m

The Proposed PoolCommissioning Area ENCCG

(£’000)

ENCCG COMMISSIONING AREAS AND SPEND

Existing CCG allocations to social care 9, 063

Hertfordshire Community Trust services for older people 21,420

Other intermediate care 2,198

Continuing Care 13,506

Carers 272

Other 4,938

Total 51,397

HERTFORDSHIRE COUNTY COUNCIL COMMISSIONING AREAS AND SPEND

Assessment and Care Management 5, 334

Residential and Nursing 36, 508

Community Services 15, 847

Direct Payments 1, 968

Flexicare Housing 2, 993

Other Older peoples 874

DFG Allocation 201516 1,588

Social care capital 1,151

Total 66,262

TOTAL BETTER CARE FUND FOR EAST AND NORTH HERTFORDSHIRE 117,659

Enhanced ENHCCG role commissioning key social care services

• Residential budget £36.5m- Focus on quality, Carehome premium and link to Enhanced Primary Care

Support to patients in care homes- Enablement bed provision• Homecare provision – £15.8m including full review of homecare contracts

in 2014/14- Discharge to Assess and ‘Home from Hospital’ homecare- Enablement care- Rapid response homecare to support HomeFirst- Dementia and End of Life

ALL OF THE ABOVE CENTRAL TO HELPING PEOPLE BE INDEPENDENT AND MANAGING ACUTE PRESSURES

Joint commissioning to deliver outcomes

Better Care Fund

Joint Commissioning National

and local

metrics

National conditions

Integrated Working

Better Care Plan-Health and Well-

Being Board

JOINT COMMISSIONING STRUCTURES WITH KEY ROLE FOR PROGRAMME BOARDS

Joint engagement events to seek views on BCF priorities for integration

(214 attendees, 86 organisations)

• Joined-up, coordinated care between statutory services, voluntary and community groups, and individuals, their families and carers

• Communication of and between services helping to support individuals in their choice of care

• Prevention and self-management to preserve good health and wellbeing

• Rapid access to community services

Emerging vision for integration

1. Services work together to maximise the independence of people in Hertfordshire

2. Effective integrated community services built around primary care

3. Jointly commission services around individuals and their needs

4. An integrated workforce, appropriately skilled and able to work across organisational boundaries

Objectives

• Improved life expectancy at 75 with narrowing variation across the County

• Reduce admissions of 65 and overs to acute care and maintain people’s independence for as long as possible

• People are re-abled and rehabilitated as effectively and quickly as possible after a crisis or exacerbation

• People die in their place of choice

Objectives continued

• There is quality care for people with dementia • Stroke patients receive timely and quality

acute care, and their rehabilitation potential is maximised

National metrics

Admissions to

residential and

care homes

Patient /

service user

experience

Avoidable

emergency

admissions

Delayed

transfers of care

Effectiveness

of reablement

Next Steps

• Develop joint governance and joint commissioning structures for Better Care Fund

• Develop joint programme to deliver integration

• Early work to get momentum- Stroke pathway- HomeFirst- Intermediate care