The Board received a presentation is to provide an overview of the Better Care Fund (BCF) programme that supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers.

The BCF (i) is aimed at bringing together health and social care organisations to plan, fund and commission integrated services; and (ii) Policy Framework sets out four national conditions that all BCF plans must meet to be approved. These are:

The paper requested approval of the BCF Plan for 2022-23 as part of the NHS England Assurance process and in line with national condition. The main points of the discussion may be summarised as follows:

The Board:

v  Noted that the Better Care Fund is not additional funding instead it represents a continuation of existing funding to support the base budget spend on integrated services. NHS North East London is responsible for planning and buying health services across north east London and supports adult social care with BCF spend on services such as community equipment, reablement teams and hospital social work teams. A full list of services funded by the Better Care Fund is included in the Better Care Fund Plan attached to the report.

v  Noted that the Better Care Fund (BCF) is aimed at bringing together health and social care organisations to plan, fund and commission integrated services. The BCF was introduced in 2016-17 for implementation and has effectively been rolled over year on year while the outcome of a national review of the programme is await.

v  Noted that the national guidance this year has seen the introduction of three new health metrics around ‘avoidable admissions’, ‘length of stay’ and ‘discharge’. The length of stay metric will be the particular focus of the national assessors. Tower Hamlets has met all the national conditions as set out in the guidance.

v  Noted that the Tower Hamlets Together Executive Board (which reports into the Health and Wellbeing Board) provides strategic oversight of the schemes that sit within the BCF. Generally, as the Fund sits within Integrated Commissioning team there is visibility of the range of budgets across the system, and a recognition that these are the areas where resources need to combine in order to deliver the collective priorities for Tower Hamlets.

v  Noted that the BCF is focussed on integrating health and social care services to better support people with a diverse range of illnesses and conditions. These include people with mental health problems, people at risk of being admitted to hospital and people being discharged from hospital with appropriate support. It also funds Reablement which supports people to learn or relearn skills necessary for daily living following ill-health or disability; the adaptation of the domestic accommodation of people with disabilities to enable them to live at home, and the training of staff in the use of assistive technology.

v  Noted that the BCF is concerned with achieving best value in the health and social care economy, by ensuring that services are provided most appropriately across the system and that the allocation of resources supports efficiency improvements, as well as better outcomes for service users. It also seeks to reduce the historic problem of financial savings in one sector being achieved at the expense of additional costs in the other, through better joint planning and shared priorities.

As a result of a full and wide-ranging discussions on the Better Care Fund Plan for 2022-23 the Chair of the Board then Moved, and it was:-

RESOLVED that:

v  any member of the Health & Wellbeing Board would be given a further opportunity to raise any queries on the Better Care Fund Plan before the formal sign off on the 26^{th of} September 2022.

NB: Subsequent to the meeting the Chair has agreed that there should be a programme of reviews/deep dives into the BCF schemes (with a focus on outcomes/impact and also addressing inequalities) that will be developed into a proposal for the Board’s Forward Plan.