Better Care Fund

3rd sector engagement event

17 March 2014

Matt Ward and Dennis Holmes

Better Care Fund

Better Care Fund – National Context

• BCF (£3.8 billion pooled budget) announced as part of

the Spending Round in June 2013 – final guidance

launched 20 December

• “The end goal is radical transformation to provide better

care” with integrated care “the norm” by 2018

• The £3.8 billion fund is the minimum amount to be

pooled; some areas may wish to go further

• Joint DH and DCLG programme, signed off locally by Health and Wellbeing Boards

Better Care Fund

Funding arrangements nationallyThe June 2013 SR set out the following:

2014/15 2015/16

An additional £200m transfer from the NHS to social care, in addition to the £900m transfer already planned

£3.8bn pooled budget to be deployed locally on health and social care through pooled budget arrangements

In 2015/16 the BCF will be created from the following:

£1.9bn additional (but existing) NHS funding

£1.9bn based on existing funding in 2014/15 that is allocated across the health and wider care system. Composed of:

• £130m Carers’ Breaks funding

• £300m CCG reablement funding

• £354m capital funding (including c.£220m of Disabled Facilities Grant)

• £1.1bn existing transfer from health to social care

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National Conditions of the BCF

The £3.8bn pooled budget will only be released to local areas with agreed plans for how it will be used which meet five “national conditions”

o Protection for social care services (not spending);o 7 day working in health and social care to

support patients being discharged and prevent unnecessary admissions at weekends;

o Better data sharing between health and social care, based on the NHS number ensure a joint approach to assessments and care planning;

o Where there are integrated packages of care, an accountable lead professional;

o Agreement on the consequential impact of changes on the acute sector.

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National measures of the BCF

Five measures to demonstrate progress towards better integrated health and social care services:

o Admissions to residential and care homes;

o Effectiveness of reablement;

o Delayed transfers of care;

o Avoidable emergency admissions; and

o Patient / service user experience.

One locally determined measure:

o Rate of diagnosis for people with dementia

Local funding make up for 2015/16

Stream Amount

Disabilities Facilities Grant £2,958,000

Social Care Capital Grant £1,844,000

NHS Leeds North CCG £12,665,000

NHS Leeds South & East CCG £17,351,000

NHS Leeds West CCG £20,105,000

TOTAL £54.9m

Better Care Fund

BCF: Leeds Context

Better Care Fund

Leeds Proposals: “Increase the number of people supported to live safely in their own homes”:  

Supporting people to stay out of hospital or residential care

Helping people to leave hospital quickly

Supporting people to stay out of hospital or residential care

BCF Work Flow

Leeds proposals in detail

2014/15: Pump-priming year £2.7m for “invest-to-save” schemes2015/16: £40m for joint recurrent schemes, already in existence. These include: Reablement Services, Community Beds, Leeds Equipment Service, Community Matrons, Supporting Carers, 3rd Sector prevention…

£14m for non-recurrent schemes, innovative initiatives These include: enhanced primary care services, Medication prompting (dementia), Eldercare facilitators, Enhancing integrated neighbourhood teams, improving use of IT, expanding community intermediate care beds, reducing ‘Frequent Flyers’, Falls Prevention, Care Bill req’s (part)

Impact of the proposed schemes

15% reduction in emergency hospital admissions = projected saving of £24m over 5 years

Leeds proposals – third sector

3rd Sector Prevention: “Health and social care services across the city are also supported by the voluntary and 3rd sectors. There are a range of organisations commissioned to provide support services including frail elderly, those with a physical disability, hearing and sight loss, mental health including dementia, stroke and advocacy services”

Key issues• Financial sustainability in health and social care

• Addressing demand and public engagement

• Future 3rd sector commissioning arrangements

• Working up and testing out the proposals in 2014/15

• Opportunities for working together to transform services?

Better Care Fund