SLIDE 1
Integrated Commissioning Board Better Care Fund 2016/17
SLIDE 2 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.
.
SLIDE 3 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
SLIDE 4 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
SLIDE 5
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
SLIDE 6 Spend Against Budget 2015/16
Spend 2015/16 Budget Spend 2015/16 Variance £000’s £000's £000's Adult Social Care Services 8,217 8,217 Care Act Implementation 594 594 Commissioning Strategy 72
Carers Services 563 526 37 Re-ablement Services 1,154 1,396
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
SLIDE 7 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
HMR CCG/Rochdale Council Pooled Budget 15,912 16,049 137
SLIDE 8
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
SLIDE 9 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)
SLIDE 10 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 Care Act Implementation 594 637 43 Commissioning Strategy 72
Carers 526 480
Re-ablement 1,397 874
Intermediate Care 5,106 5,841 735 Total Revenue Expenditure 15,912 16,049 137
SLIDE 11
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
SLIDE 12 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
SLIDE 13
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 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
SLIDE 14 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!
