North Yorkshire Council

 

Health and Wellbeing Board

 

14 March 2025

 

Update of the Better Care Fund 2025/26 Planning Requirement and approval of the 2024/25 Qtr 1, Qtr 2 and Qtr 3 monitoring returns

 

Report of the Director of Public Health

 

1              PURPOSE OF REPORT

 

1.1          To update Health and Wellbeing Board on the 2025/26 Better Care Fund Planning Requirement and to seek approval of the Quarterly return for quarters 1, 2 and 3 of 2024/2025.

 

2          BACKGROUND

 

            The Better Care Fund 2025/26

 

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       The Better Care Fund requirement for 2025/26, published on 30 January 2025, saw some key changes since the previous two-year plans for 2023-25.

a) A final submission date from 19 July 2023 for the 2023-25 Better Care Planning requirement to 31 March 2025 for 2025/26. This has meant that earlier than anticipated work has been undertaken and Appendix 1 shows the most up to date plan as of present, with work still on-going up to the end of March 2025 to finalise the submission is taking place.

b) The Chief Executive officers at all four organisations needs to sign off the 2025/26 BCF Plans before the final submission deadline of 31 March 2025, and this cannot be delegated. There is also an additional requirement that the BCF Plans are to be signed off by the Local Authorities S151 Officer before the submission deadline. The BCF 2025/26 Plan still needs Health and Wellbeing Board sign off, however, this can take place after the deadline of 31 March 2025. The Health and Wellbeing Board will therefore sign off the Better Care Fund submission on 16 May 2025.

            c) The Local Authorities’ Adult Social Care Discharge Funding (£4.05m) and the Improved Better Care Fund (£17.33m) has been amalgamated into a new grant named Local Authority Better Care Grant (£21.38m 2025/26 with no uplift from 2024/25).

d) The ICBs’ Adult Social Care Discharge Funding (£4.93m) has been transferred into the NHS Minimum Contribution allocation.

            e) The ICBs are required to passport a set amount of the ‘NHS Minimum Contribution’ to Local Authorities to support Adult Social Care.
Local Authorities have seen an increase of 3.93% for this allocation to 2025/26 from 2024/25 (NYC 2025/26: £20.0m from 2024/25: £19.2m), with the ICBs for North Yorkshire HWB have seen a less than 1% increase in funding allocation from the NHS Minimum Contribution.

            f) For the forthcoming year, the aim is to streamline the planning and reporting process for the health and wellbeing board areas (HWB areas). In addition, the quarterly monitoring returns in 2025/26 will require sign off by the Health and Wellbeing Board before submission. Steps will be taken to build this into the current process to ensure that the obligations are met.

 

2.4       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.    Implementing the BCF policy objective 1: Reform to support the shift from sickness to prevention.

 

Implementing the BCF policy objective 2: Reform to support people living independently and the shift from hospital to home.

3.    Complying with grant and funding conditions, including maintaining the NHS minimum contribution to adult social care (ASC)

 

4.    Complying with oversight and support processes

 

2.5       The Council and partners are confident that the submission will meet these conditions.

 

2.6       The one-year Section 75 for 2025/26 to be agreed by all four parties by 30 September 2025

 

 

3.1       The Quarterly Reporting 2024/25
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. The key purposes of BCF reporting is to confirm the status of continued compliance against the requirements of the fund (BCF)

·                     In Quarter 1, the focus was on Discharge Grant funding spend and activities and excluded and updates to the metrics. North Yorkshire and the ICBs reported that both spend and activity levels for the plan were in line with planned outputs for 2024/25.

·                     In Quarter 2 and 3, metrics data including narrative around any variance from plan and mitigation for recovery was requested. North Yorkshire and the ICBS reported that they were on track to meet targets for 2024/25. In addition, spend to date was requested in which North Yorkshire and the ICBS stated that there were in line with planned outputs.

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 1).

 

4          LEGAL IMPLICATIONS

 

4.1       It is a statutory requirement that 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. For the BCF 2025/26 submission, there is now an additional requirement for the Chief Executives at each organisation for HWB North Yorkshire and the North Yorkshire Council’s s151 Officer and the Chief Finance Officers at the ICBs to sign off the final plans before submission on 31 March 2025.

 

4.2       In terms of monitoring, it is also a requirement that the Quarterly Returns are approved by the Health and Wellbeing Board (HWB). The BCF 2024/25 Planning Requirement allows the quarterly returns to be signed off by HWB after submission, whilst the BCF 2025/26 Planning Requirement requires signed off by the HWB prior to submission.

 

5          FINANCIAL IMPLICATIONS

 

5.1       The following minimum funding must be pooled into the Better Care Fund in 2024/25 and 2025/26:-

 

BCF Schemes – 2024/25

·         2024/25 total BCF funding is £84.3m (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 £6.4m

 

BCF Schemes – 2025/26

·         2025/26 total BCF funding is £85.1m (LY £84.3m).

·         The ICBs’ BCF NHS Minimum Contribution in 2024/25 is £57.3m (LY £51.5m) of which £20.0m is transferred to NYC for Adult Social Care (LY £19.2m);

·         NYC iBCF allocation of £17.3m transferred to the new LA Better Care Grant (LY £17.3m).

·         The total ASCDF, (Additional discharge funding) for North Yorkshire is £9.1m; NYC £4.1m and ICBs £5.0m. The LA Adult Social Care Discharge funding has of £4.1m has been transferred to the new LA Better Care Grant and the ICBs’ Adult Social Care Grant has been amalgamated within the NHS Minimum Contribution.

·         LA Better Care Grant £21.4m (iBCF £17.3m and LA ASCDF £4.1m)

·         DFG, (Disabled Facility Grant) for NYC is £6.4m

 

 

6          EQUALITIES IMPLICATIONS

 

6.1       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.

 

7          CLIMATE CHANGE IMPLICATIONS

 

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

 

8          CONCLUSIONS

 

8.1       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.

 

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

 

9          REASONS FOR RECOMMENDATION

 

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

 

10        RECOMMENDATIONS

 

10.1     a) to note the Better Care Fund 2025/26 Planning Requirement

b) and, that the Quarterly Returns for Quarters 1, 2 and 3 in respect of 2024/2025 to 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 2025/26 and 2024/25

 

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