Integrated Commissioning Board

Better Care Fund 2016/17

What is the Better Care Fund?

• Announced in June 2013 to drive forward transformation of local Health

and Social Care Services.

• The Care Act 2014 amended the NHS Act 2006 to provide the legislative

basis for the Better Care Fund.

• NHS England required to ring-fence allocations to Clinical Commissioning

Groups (CCG’s) to establish the Better Care Fund.

• Social Care Capital grant and Disabled Facilities Grant to form the

remaining amounts for the fund, which were paid directly to Local

Authorities.

• A requirement that the Better Care Fund is transferred into one or more

pooled funds established under section 75 of the NHS Act 2006.

.

Key Financial Aspects of the Section 75 Agreement

• Contains details of the contractual commitments

• The Local Authority is host and the Section 151 Officer is the

Pooled Fund Manager

• Quarterly monitoring reports to the Integrated Commissioning

Board

• Revenue under and overspends are shared equally between

both partners

• Unspent capital allocations return to the Local Authority

How is it Governed?

National Requirement:

• A requirement that Health and Wellbeing Boards jointly agree

plans for how the money will be spent, with plans signed-off

by the relevant local authority and Clinical Commissioning

Group(s)

Local Process:

• Established the Shadow Integrated Commissioning Board with

delegated powers from HWBB, Governing Body and Cabinet

NHS England Better Care Fund Allocations and

Pooled Budget Value

2015/16

£000’s

Ring fenced allocations to CCG’s (minimum

value of BCF)

15,125

HMR CCG/Rochdale Council Pooled Budget 15,912

CCG Contribution above the required minimum

value

787

Spend Against Budget 2015/16

Spend 2015/16 BudgetSpend

2015/16Variance

£000’s £000's £000's

Adult Social Care Services 8,217 8,217 0

Care Act Implementation 594 594 0

Commissioning Strategy 0 72 -72

Carers Services 563 526 37

Re-ablement Services 1,154 1,396 -242

Intermediate tier service prior to phase 2 1,847 1,729 118

Intermediate tier service Phase 2 3,537 3,378 159

Total Better Care Fund Revenue Spend 15,912 15,912 0

2016/17 Better Care Fund (BCF)Allocations

Compared to 2015/16

2015/16

£000’s

2016/17

£000’s

Change

£000’s

Ring fenced

allocations to CCG’s

(minimum value of

BCF)

15,125 15,560 435

CCG Contribution

above the required

minimum value

787 489 -298

HMR CCG/Rochdale

Council Pooled

Budget

15,912 16,049 137

2016/17 Significant Increased Requirements

Description Increased Contract

Commitments 2016/17

£000’s

Reason

Care Act Implementation 43 In line with NHS Guidance

Equipment Loan Store 248 Demand pressures

Intermediate Tier Service 457 Full year impact of new

contract

Total Increased

Requirements 748

Review of Commissioning Activity to balance the

2016/17 Budget

LA/CCG commissioners reviewed the commitments and propose the

following:

• No inflation uplifts to Adult Social Care Services and the Council’s carers

and Re-ablement Services

• Assistive Technology to be funded from Capital

• Equipment loan store costs to be part funded from Capital

• Removal of contracts now funded through the Integrated Neighbourhood

Team (INT) contract

• Removal of outreach contract now provided for in the Intermediate Tier

Service

• Hospital to home service decommissioned (already actioned)

2016/17 Budget against 2015/16 Spend

Spend

Final

Outturn

2015/16

2016/17

Budget

Variance

£‘000s £’000s £‘000s

Revenue Expenditure

Protection of Social Care Services 2015/16 8,217 8,217 0

Care Act Implementation 594 637 43

Commissioning Strategy 72 0 -72

Carers 526 480 -46

Re-ablement 1,397 874 -523

Intermediate Care 5,106 5,841 735

Total Revenue Expenditure 15,912 16,049 137

2016/17 In Year Reviews to be undertaken

New Carers

Service £484k

Life after stroke

Service £130k

Dementia

Support Workers

£81k

Dementia

Flexible Workers

£60k

Mental Health

Outreach

Workers £100k

Memory Clinic

Dementia

Workers £48k

Equipment Store

£585k revenue

plus £35k capital

Equipment Loan Store

• In 2015/16, the budget for the loan store was £337k and was over spent by

£337k (£77k being a provision for potential VAT liabilities)

• Additional budget has been assigned to the loan store for 16/17 to cover

this (£248k in Revenue and £35k in Capital)

• A review of the loan store is under way. The review includes:

• Transfer of the ownership of the budget to Pennine Acute through

the INT contract

• Review of the number of expensive same day / next day ordering

• Review of direct correlation of costs increases as a result of more

care at home

• Review of the timeliness of collecting items no longer needed by

patients

Better Care Fund Capital Allocations and Spend

2015/16

£000’s

2016/17

£000’s

Disabled Facilities Grant 1,122 2,047

Capital Grant 617 0

Total Capital Budget 1,739 2,047

Capital Spend:-

Disabled Facilities Main

Programme 1,015 1,571

Minor Adaptations 107 100

Assistive Technology 200

Springhill 141

Equipment (Loans Store) 35

Total Spend 1,122 2,047

Variance 617 0

Future of the Better Care Fund

Influenced by :

• Lessons learnt during 2015/16

• Local decisions on future pooling

• National decisions

• Greater Manchester decisions re devolution

• More will follow!