Agenda item

To seek the Board’s endorsement of plans for the use of funding received through the Better Care Fund (BCF), including £2.6m of additional funding intended to support discharge from hospital during the winter months.  The report will be presented by Neil Bradley, Director of Adult Services, and Rachel Mitcheson, Director of Place and Integrated Services – Northumberland.

Members received a report seeking endorsement of plans for the use of funding received through the Better Care Fund (BCF), including £2.6m of additional funding intended to support discharge from hospital during the winter months.  The report was presented by Neil Bradley, Director of Adult Services and Rachel Mitcheson, Director of Place and Integrated Services – Northumberland.

Neil Bradley explained that the guidance for the submission of the plan for Better Care Fund had not been published until late July with a requirement to submit the plan by 26 September 2022.  It had not been possible to seek approval by the Health & Wellbeing Board.  Details of further funding, the Adult Social Care Discharge Fund, had been published in November 2022.  As it had not been possible to seek approval by the Health & Wellbeing Board before submitting plans, the Board was now being asked for ratification.

The BCF funding was recurrent funding whereas the Discharge Fund had to be spent within the financial year.  From the Local Authority point of view much of the BCF funding went into domiciliary care services.  Funding had also been put into the hospital discharge team which had been able to grow substantially.  Appendix 1 of the report outlined expenditure in the BCF plan for 2022/23 and was entrenched in core services.  Funding was split into three areas:-

•       Core funding via the ICB

•       The improved BCF which came direct to the County Council, although there was a requirement to consult with the ICB as to how this funding was used.

•       ICB’s own part of the BCF which was predominantly allocated to community services

Regarding the Adult Social Care Discharge Fund, time had been limited to make plans to use this funding effectively.  Capacity of the workforce was currently the biggest problem within social care along with the very short timescale available to use the funding.  Schemes had been identified which it was hoped would be able to make use of the funding over the next three months.  The following had been identified:-

•       Bringing forward the Living Wage pay award to carers working in domiciliary care and residential and nursing care.  It was hoped that this would stem the flow of workers out of this sector. 

•       More flexible solutions for domiciliary care support which would bring together different groups of carers and residents to offer a more flexible service.  Live in carers may be possible where there were transport difficulties.

•       Equipment including specialist beds could be provided to help get people out of hospital, thereby freeing up beds.

•       Some beds in care homes had been block booked along with some out of area dementia beds. 

•       Premium payments to care homes offering rapid discharge

•       Short term support service – extend into overnight care for patients on discharge from hospital.  There would be no new recruitment, but overtime would be offered to existing staff.

The following comments were made:-

•       Northumberland Communities Together was the main interface with the voluntary sector in relation to the hospital discharge schemes and in mainstream community provision.  There was an existing problem with the provision of care with a number of packages of care which could not be met.  

•       Healthwatch welcomed the proposals and addressed issues which people had come to it about.  Communication with patients, families and the community sector remained a big issue. 

•       Work was being done around virtual wards.  It was aimed to get people home from hospital and into their own environments and was a clinical model.

•       The impact of the wage increase was uncertain, but it was a route taken in many other areas across the country.  Regarding the bulk buying of beds, there was an argument to favour bulk buying beds for intermediate care.  The ICB may be asked whether the intermediate bed provision was right to deal with the scale of the problem. 

RESOLVED that

(1)    the main contents of the Better Care Fund Plan for 2022/23 as set out in Section 1 of the background to the report be endorsed.

(2)    The contents of the additional plan submitted to the Department of Health and Social Care for the use of the Adult Social Care Discharge Fund during the current winter as set out in Section 2 of the background of this report be endorsed.