North Yorkshire Council
Health and Wellbeing Board
16th May 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 seek approval from Health and Wellbeing Board on the 2025/26
Better Care Fund Planning Requirement submission and of the
Quarterly return for quarters 1, 2 and 3 for 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 was undertaken by North
Yorkshire Council in collaboration with the three ICBS. The final
submission has been approved by all Chief Executives and Chief
Officers as the new requirement, with WY ICB and H&NY ICB
meeting the deadline of 31 March 2025, followed by North Yorkshire
Council on 2 April 2025 and L&SC ICB on 14 April 2025. Appendix
1 shows the final submission including the BCF Narrative, Planning
template and Capacity and Demand template.
b) The Chief Executive officers at all four organisations needed to
sign off the 2025/26 BCF Plans the final submission deadline of 31
March 2025, and this could not be delegated. There was also an
additional requirement that the BCF 2025/26 Plans to be signed off
by the Local Authorities S151 Officer and the ICBs Chief Finance
Officers by the submission deadline. However, the BCF 2025/26 Plan
still requires Health and Wellbeing Board sign off, which can take
place after the deadline of 31 March 2025.
c) The Local Authorities’ Adult Social Care Discharge Funding
(£4.1m) and the Improved Better Care Fund (£17.3m) has
been amalgamated into a new grant named Local Authority Better Care
Grant (£21.4m 2025/26 with no uplift from 2024/25).
d) The ICBs’ Adult Social Care Discharge Funding
(£5.0m) 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 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 BCF 2025/26 Plan
submission was approved at the national Better Care Fund panel on
24th April however with two conditions attached. The
conditions relates to the Metric 8.2 in planning template for the
‘Proportion of Adults Patients Discharged from Acute
Hospitals on their DRD’ and in which the % provided compared
to the other Better Care Fund plans in the Yorkshire and Humber area was a lower than average
outlier whilst the second conditions related to the ‘Average
length of discharge delay for all acute adult patients’ was
higher than the average within the Yorkshire and Humber area.
Currently the national Better Care Team is finalising the details
around these conditions, however they are likely to be around
reviewing data quality and improving ambitions.
2.6 The one-year Section 75 for 2025/26 is 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 are 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 (Quarter 1, 2
and 3 in Appendix 2).
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 was 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 £84.2m (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 £6.3m.
BCF Schemes – 2025/26
· 2025/26 total BCF funding is £85.1m (LY £84.3m).
· The ICBs’ BCF NHS Minimum Contribution in 2025/26 is £57.4m (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 £6.3m.
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 approve the Better Care Fund
2025/26 Planning Requirement submission and note the two
conditions;
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 2023-25
NOTE: Members are invited to contact the author(s) in advance of the meeting with any detailed queries or questions.