North Yorkshire Council

 

Health and Wellbeing Board

 

19 July 2024

 

Approval of the Better Care Fund update 2024/25 and 2023/24 Outturn monitoring return

 

Report of the Director of Public Health

 

1          PURPOSE OF REPORT

 

1.1          To seek approval to:-

 

a)    the Better Care Fund Planning Update Submission for 2024/2025; and

 

b)    The Quarterly Outturn return for the final quarter of 2023/2024.

 

2          BACKGROUND

 

            The Better Care Fund 2023-2025

 

2.1       The Better Care Fund is a Government initiative which creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services.  It was introduced in 2015 to support local systems to successfully deliver the integration of health and social care.

 

2.2       In North Yorkshire it is, essentially, a partnership between the Council and the three Integrated Care Boards that operate within the Council’s footprint, namely:-

 

-       NHS Humber and North Yorkshire ICB

-       NHS Lancashire and South Cumbria ICB

-       NHS West Yorkshire ICB

 

2.3       Partners have agreed the following headline priorities for 2023-2025:-

 

·           Priority 1 – A comprehensive and integrated health and social care model

·           Priority 2 – A high quality care sector, with sufficient capacity to meet demand

·           Priority 3 – A strong workforce

·           Priority 4 – Prevention and Public Health

 

2.4       For each Priority, the plan highlights asks What does good look like? and encompasses a number of key actions that are intended to make these aspirations a reality.

 

2.5       There are a number of national conditions that all Better Care Fund Plans must meet in order to be approved. These are:-

 

1.    A jointly agreed plan between local health and social care commissioners and signed off by the Health and Wellbeing Board.

2.    NHS contribution to adult social care to be maintained in line with the uplift to NHS minimum contribution.

3.    Invest in NHS commissioned out-of-hospital services.

4.    Implementing the two BCF policy objectives.

 

2.6       The Council and partners are confident that the submission meets these conditions.

 

2.7       There have been some changes since the previous Plan.  Among these, are the planning and funding cycle increased to two years to provide greater certainty around funding and spend, revisions to include additional expenditure and reflect updated spend including uplift, where appropriate and the fact that the Disabled Facilities Grant is now managed by North Yorkshire Council, following the merger of the District and Borough Councils with the former County Council to create a single authority – North Yorkshire Council – on 1st April 2023.

 

2.8       The 2023-25 Better Care Funding Planning guidance was submitted on 19th July 2023 to NHS England.

 

2.9       Official approval letter for formal permission to spend was received on 18th September 2023 from NHS England.

2.10     The two-year 2023-25 Section 75 has been agreed by all four parties.

2.11     Better Care Fund Planning 2024/25 requirement update
On the 12th April an Addendum to the Planning Requirements and Policy Framework 2023-25 was published, which outlines the requirements for the 2024/25 planning updates.

 

2.12     The 2023-25 Planning Requirements and Policy Framework still stand for the two-year period and, as such, the majority of the North Yorkshire 2023-25 plan remain as submitted and approved for this year, however with changes to some of the funding allocation (Appendix 1)

2.13     The 2024/25 update is specifically to review and finalise the Additional Discharge Fund elements of plans, to agree ambitions for metrics and a capacity and demand plan for the second year as well as a chance to submit updates to 24/25 spending plans if required.

2.14     The Better Care Fund Planning 2024/25 requirement update was submitted by the deadline of 10th June 2024 and was put forward for approval at the BCF Assurance Panel on 3rd July. In addition, national guidance requires that the 2024/25 Planning update is approved by the Health and Wellbeing Board.

 

 

 

 

2.15     The Quarterly Reporting
Quarterly monitoring reporting is a standing requirement of the Better Care Fund planning and reporting cycle and sitting alongside the submission of the annual Better Care Fund Plan.

 

2.16     Quarter 4 - Outturn
The quarterly report template for Quarter 4 requested a financial update on a pre-selected number of scheme in which moves within spend envelop was reported.

North Yorkshire Council has not significantly changed the demand and capacity figures as systemwide data is one of the challenges it has and that is not shifted. This was reflected in the metrics which at outturn showed that four out of five metrics not on track to meet target.  On-going collaboration between the ICBs and NYC to improve data is taking place with support from the BCF team (Appendix 2).

 

3          LEGAL IMPLICATIONS

 

3.1       It is a statutory requirement for the Local Authority and its health partners to produce an agreed, fully costed Better Care Fund Plan and for that to be signed off by the Health and Wellbeing Board

 

3.2       In terms of monitoring, it is also a requirement that the re-established Quarterly Returns are approved by the Health and Wellbeing Board.

 

4          FINANCIAL IMPLICATIONS

 

4.1       The following minimum funding must be pooled into the Better Care Fund in 2023-25:-

 

BCF Schemes – 2023/24

·         Total BCF funding 2023/24 is £77.1m (LY£68.6m).

·         The ICBs’ BCF Minimum Contribution in 2023/24 is £45.8m (LY £46.1m) of which £18.2m is transferred to NYC for Adult Social Care (LY £17.2m);

·         LA’s iBCF allocation is £17.3m (LY £17.3m).

·         The total ASCDF, (Additional discharge funding) for North Yorkshire is £5.9m; NYC £2.4m and ICBs £3.5m.

·         DFG, (Disabled Facility Grant) for NYC is £5.1m

 

BCF Schemes – 2024/25

·         2024/25 total BCF funding is £83.5m (2023/24 £77.1m).

·         The ICBs’ BCF Minimum Contribution in 2024/25 is £51.5m (LY £45.8m) of which £19.2m is transferred to NYC for Adult Social Care (LY £17.2m);

·         NYC iBCF allocation is £17.3m (2023/24 £17.3m).

·         The total ASCDF, (Additional discharge funding) for North Yorkshire is £9.1m; NYC £4.1m and ICBs £5.0m.

·         DFG, (Disabled Facility Grant) for NYC is £5.6m

 

4.2       The programme and initiatives for its success are in part funded through national grants: Better Care Fund, additional Discharge Fund, Improved Better Care Fund and Disabled Facilities Grant (2023/24: £77.1m and 2024/25 £83.5m). The first two come from the Department of Health and Social Care through the ICB, while the latter two are received by the local authority from Department for Levelling Up, Housing and Communities. All are dependent on meeting conditions that contribute towards the programme and the targets, and that plans to this effect are jointly agreed between the Integrated Care Board and the Local Authority under a pooled budget arrangement

 

5          EQUALITIES IMPLICATIONS

 

5.1       There are no direct equalities implications but attainment of the priorities in the Plan will, for example, enable more people to live safely and independently.

 

6          CLIMATE CHANGE IMPLICATIONS

 

6.1       An initial climate change assessment form has been completed and that indicates that there are no direct climate change implications.

 

7          CONCLUSIONS

 

7.1       The Better Care Fund (BCF) is a programme spanning both local government and the NHS which seeks to join-up health and care services, so that people can manage their own health and wellbeing and live independently in their communities for as long as possible.

 

7.2       Monitoring of the Fund helps ensure the priorities are being achieved

 

8          REASONS FOR RECOMMENDATION

 

8.1       The content of the Plan has been agreed with partners and is fully costed.

 

9          RECOMMENDATIONS

 

9.1       That the Better Care Fund Plan Update for 2024/2025 be approved; and

 

9.2       That the Quarterly Return for Quarters 4, in respect of 2023/2024, be approved.

 

 

Author

 

Saskia Calton, Head of Finance – Public Health

Saskia.Calton@northyorks.gov.uk

 

Presenter

 

Louise Wallace, Director of public Health

Louise.Wallace@northyorks.gov.uk

 

BACKGROUND DOCUMENTS relied upon in the preparation of this report – Better Care Fund Policy Framework and Planning Requirement 2023-25

 

NOTE:  Members are invited to contact the author(s) in advance of the meeting with any detailed queries or questions.