Agenda item

To consider a report of the Corporate Director for Corporate and Support Services (Stockport Council)

The Board will be invited to consider matters arising from guidance issued by NHS England in relation to the operation and monitoring of the Better Care Fund.

Officer contact: Simon Finch, 0161 474 4019, simon.finch@stockport.gov.uk

A joint report of the Chief Finance Officer (Stockport Clinical Commissioning Group) and the Corporate Director for Corporate & Support Services (Stockport Council) was submitted (copies of which had been circulated) informing the Board of the proposed monitoring arrangements for the Better Care Fund (BCF) in light of recently published guidance by NHS England. The report also contained the first monitoring report for the Fund covering the period January to March 2015.

The following comments were made/ issues raised:-

·         Discussions were ongoing between the Clinical Commissioning Group (CCG), the Council and Foundation Trust in relation to changes to the tariff level for the Non-Elected Admissions and the impact this change will have on the Performance Fund and contingency resources planned into the BCF at the time of submission.

·         Clarification was sought on the likely achievement of the national conditions (3) relating to 7 day services and (5) relating to joint assessments and care planning, both of which Stockport had not yet met. In response it was stated that there was further work underway to develop 7 days services as further consideration needed to be given to potential changes to employee terms and conditions with any changes subject ot appropriate consultation. Further analysis was needed as to the likely demand for services outside of current delivery hours and the appropriateness of offering certain services at weekends. In relation to joint assessments it was stated that in some areas joint assessments were already being undertaken but that the Vanguard project would used to attempt to overcome the technical problems associated with more widespread adoption of joint assessments. It was anticipated that this would begin to be implemented by October. In the case of both conditions it was unlikely that they would alter to ‘yes’ responses in the next monitoring report.

·         Further proposals were being considered by the Leaders of each of the organisations involved in Stockport Together to accelerate the roll-out of the locality hub model. Building on the experience of the Marple and Werneth Hub it was planned to ensure that the establishment of the Cheadle & Bramhall Hub could be achieved by October 2015, in part by tackling first those areas that had created barriers to the implementation of the previous Hub. This would also be facilitated by the Vanguard work. It remained the intention for the whole of Stockport to working under a new model of delivery for the financial year 2016/17, although this may be in tandem with more traditional service models in the short term.

·         In relation to the Greater Manchester devolution and health & social care integration agenda, it was commented that Stockport Together needed to proceed at a faster pace than the Greater Manchester activity, but that local work was within the broad parameters of the Greater Manchester agenda. Stockport was developing a community centred model, in contrast to Salford’s hospital centred model, but that the involvement of Vanguard would provide additional support to the work locally. Colleagues working across Greater Manchester were co-ordinating a range of plans by local authorities, CCGs and NHS Trusts to determine where proposals may be amended to better complement the overall Greater Manchester agenda and also where collaboration between local authorities may provide increased benefits. Healthier Together would also be progressed and decision was expected during Summer 2015.

·         In response to questions about 24/7 working, it was commented that recent piloting of increased access to GP services had not demonstrated a clear case for its expansion as the effect on other, more costly NHS services was not of the scale to off-set the additional expense. Further consideration was therefore needed as to the nature of the services available outside of traditional hours, such as screening or preventative services. There was a significant role to play for the use of technology and information to better target those at higher risk.

RESOLVED – (1) That in relation to the Better Care Fund Monitoring Report for period January to March 2015:-

·         the release of Better Care Fund Guidance and the key points detailed in this report be noted;

·         the target reduction in non-elective admissions within the BCF and the final CCG operational plan being within the 2% tolerance be noted

·         notwithstanding the non-achievement of the Quarter 4 target for non-elective admissions as set out in 4.2 of the report, no change be made to the BCF target at this point;

·         the intention to review the Performance Fund in June 2015 following the release of the NHS England analytical tool be noted; and

·         the first Better Care Fund Monitoring Report be approved for reporting to NHS England on 29 May 2015.

(2) That the Chief Operating Officer and Director of Public Health be requested to submit a report to a future meeting on the outcomes of the recent Blood Pressure Awareness Campaign.