The Sub-Committee received a presentation on the Better Care Fund (BCF) to provide (i) a timely update of recent actions relating to the BCF which will include an overview of the considerations and outcome of the Borough’s internal BCF review, updating on proposed and future changes to the BCF (including areas for future integration); and (ii) an update on changes made to our recently submitted 2021-22 Better Care Fund plan and associated Section 75. A summary of the questions and feedback provided is outlined below:

v  Noted that in terms of how people navigate the disabled facilities grant system, I think one of the ways in which we are trying to do that is through the Tower Hamlets connect which serves as an access point to Adult Social Care services in the Borough that help residents to live an independent, healthy, and fulfilling life.  It provides free, independent, quality-assured information, advice and advocacy across health, social care, and social welfare to resolve issues and to prevent or delay any needs or problems from getting worse.  However, the Council have recognised in the review that was undertaken earlier in the year that there is work to be undertaken around the Disabled Facilities Grant and how that is used and how better use could be made of the Grant such as the prioritisation of high risk care packages and fast tracking of adaptations for people and having a real focus on getting that money spent e.g. putting in a handrail on the stairs; building a ramp up to afront door or bigger works like stair-lifts or showers.

v  Noted that the council is committed to making disabled facilities grant available to all eligible owner-occupiers, tenants, and property owners, so that disabled residents can remain safe and independent in their own homes.

v  Noted that when people have finished with equipment they can be collected and the recycling rate of equipment is good and the Council does well in terms of people being able to give back equipment that they no longer need, and that being used again where it is appropriate for other people.

v  Noted that all Clinical commissioning groups (CCGs) will be merged across their integrated care system (ICS) boundaries by April 2022, as part of proposed changes to legislation designed to hand ICSs the direct commissioning power.  It will also create a ‘single pot’ of funding, bringing together CCG commissioning and primary care budgets along with other funding allocated to systems.

v  Noted that a briefing paper could be prepared for the Sub-Committee on the proposals about what it means for Tower Hamlets.

v  Noted that the Health and Well-Being Board will be asked to approve the Better Care Fund Plan for 2021-22 as part the NHS England Assurance process and due to the late issuing of guidance and scheduling of Health and Wellbeing Boards this year this will be a retrospective approval (due to the plan having been submitted from assurance on the 16th of November 2021). However, an item was brought to the 21st of September meeting of the Health and Wellbeing Board which discussed the internal review and future plans.

v  Understood that the Better Care Fund is overseen by the Health and Wellbeing Board and the Tower Hamlets Together Executive Board and that both these Boards are made up of a wider range of stakeholders from across our health and care system including voluntary sector representatives.  The 2021-22 BCF plan is an evolution of the 2020-21 arrangements. The priorities have been developed through the Tower Hamlet Together (THT) Executive Board, the borough based integrated health care partnership, which includes key members from the Health and Wellbeing Board.

v  Noted that any overspend within Better Care Fund falls where the money has originated form (e.g., if it is an overspend in terms of Council spend it is the Council who is accountable for that and the reporting of the overspend will be done as part of the Council’s normal monthly budget reporting). In addition, there are quarterly finance reports to Tower Hamlets Together that look at pressures in the system and these would include where there are overspends as well.  Whilst whether that is on the Council side or on the NHS side that forms part of the reporting back to the Health and Well-Being Board.

v  Agreed that budgetary pressures are one of the areas of concern that should be the subject to regular scrutiny by Members.

v  Noted that Telecare or assistive technology that (i) reminds and inform people, and their carers, about things that need to be done around the home; (ii) alerts a family member or carer that a person has got out of bed at night and needs assistance, or (iii) may alert a monitoring centre that something has happened, and that appropriate action should be taken. 

v  Agreed that Telecare could be one of those services considered in any future scrutiny of the budget (e.g., realignment work and overspends).

v  Noted the range of services the Telecare department deliver, including monitoring Domestic Violence alarm, out of hours homeless response. The committee heard that the Council would be undertaking a review of the out of hours response.

Following a full and wide-ranging discussion, the Chair thanked all those Committee Members in attendance and to (i) Warwick Tomsett (ii) Suki Kaur and (iii) Phil Carr for a brilliant presentation on this important issue.