integrated commissioning board better care fund...
TRANSCRIPT
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Integrated Commissioning Board
Better Care Fund 2016/17
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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.
.
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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
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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
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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
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Spend Against Budget 2015/16
Spend 2015/16 BudgetSpend
2015/16Variance
£000’s £000's £000's
Adult Social Care Services 8,217 8,217 0
Care Act Implementation 594 594 0
Commissioning Strategy 0 72 -72
Carers Services 563 526 37
Re-ablement Services 1,154 1,396 -242
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 0
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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 -298
HMR CCG/Rochdale
Council Pooled
Budget
15,912 16,049 137
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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
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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)
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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 0
Care Act Implementation 594 637 43
Commissioning Strategy 72 0 -72
Carers 526 480 -46
Re-ablement 1,397 874 -523
Intermediate Care 5,106 5,841 735
Total Revenue Expenditure 15,912 16,049 137
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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
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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
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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 0
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 0
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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!