Agenda item

2.55

10 minutes

Persons responsible:          Chief Executive, OCCG and Director for Adult Services, OCC

Persons giving report:         As above

The attached report (HWB9) aims to update the Board on developments of the improved Better Care Fund implementation and related Delayed Transfers of Care (DTOC) measurements. 

The Board is RECOMMENDED to review and endorse the iBCF plan.

The Board is RECOMMENDED to note and confirm the planned DTOC trajectory set out at paragraph 8 endorsed on behalf of the Board by the Leader of the Council with the agreement of OCCG and system partners on 26^th September 2017.

The Board is RECOMMENDED to endorse the planned investment of the iBCF and to note  the risk to the future funding from the Government if the schemes that have been identified do not deliver a reduction in delayed discharges in line with the agreed trajectory

The Board is RECOMMENDED to critically appraise and endorse the performance measures that are proposed to be used to assure the delivery of the agreed trajectory

The Board is RECOMMENDED to agree a reporting regime to ensure effective delivery.

(2 papers attached)

Dr Barbara Batty, OCCG and Benedict Leigh, OCC gave an update (HWB9) on the development of the improved Better Care Fund (BCF) implementation and delayed Delayed Transfers of Care (DTOC) measurements. The Board was asked to review and endorse the Improved Better Care Fund Plan.

Dr Batty reported that all agencies had worked together and plans had now been finalised for delivery.

Professor Smith challenged that, in HWO’s view, the best conceivable value for money was to provide more help and support for carers in a climate where the availability of respite had declined, together with interaction with carers.

Dr McManners gave the view that, in his view, the HART service was too focused on hospital discharge, in a situation where a patient required a high level of hospital intervention. Dr Batty agreed adding that GPs spent a lot of time trying to avoid patient admission to hospital and therefore failing to access the HART service for them. However it was understood that people could self – refer. In reality, GPs would refer if there was no support at home.

In response to a query about how the HART service will work with the rising complexity of cases to deal with, given that patients would be sicker and suffering from more complicated illnesses. Kate Terroni responded that it was about ensuring that there was sufficient scrutiny in place in this area to ensure people have the correct level of care. Dr Batty added that one of the risks will be that people will be receiving earlier and bigger care packages and more care at home.

In response to a challenge that there should be more notional savings given that an expensive acute bed would be freed up and that money should be identified for staffing and retained within the system, David Smith responded that this would be part of the work around the workforce strategy within the acute Trust. The Trust Board would be re-gearing the system to look at where the best value was and the best benefit for patients.

The Board AGREED to:

(a)  endorse the Improved Better Care Fund Plan;

(b)  note and confirm the planned DTOC trajectory as set out in paragraph 8 , endorsed by the Leader of the Council with the agreement of OCCG and system partners on 26 September 2017;

(c)  endorse the planned investment of the iBCF and to note the risk to the future funding from the Government if the schemes that have been identified do not deliver a reduction in delayed discharges in line with the agreed trajectory;

(d)  critically appraise and endorse the performance measures that are proposed to be used to assure the delivery of the agreed trajectory;

(e)  to request that this item be brought to each future meeting, together with information on the situation with regard to the questions posed regarding the HART service, as set out above; and the trajectory numbers; and

(f)    request the Director of Adult Social Care to ensure where possible that any extra payments of care to agencies are passed down to care workers.