Agenda item

Cabinet Member: Adult Social Care

Forward Plan Ref: 2023/082

Contact: Ian Bottomley, Lead Commissioner Age Well Support, ian.bottomley@oxfordshire.gov.uk

Report by Interim Corporate Director for Adult Social Care (CMDASC4).

The Cabinet Member for Adult Social Care is asked to

a)    Approve

               i.         the Agreement of a s75 NHS Act 2006 pooled commissioning budget with Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board from 1 April 2023. The draft Agreement is attached as Annex 1.

              ii.         delegation to Corporate Director of Adult Services and the Council s151 Officer to finalise the Agreement prior to signature in line with the Council’s scheme of delegation

             iii.         the financial contributions as set out at paragraph 10 and the risk share set out at paragraph 30. 

b)    Note

               i.         The Agreement will commence on 1 April 2023. It has been approved for completion by the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board at its meeting on 21 March 2023. The Agreement replaces that dating from 1 April 2013 with the former Oxfordshire Clinical Commissioning Group

              ii.         The Agreement gives authority to, and binds, the Council and the ICB to pool financial and other resources to deliver better outcomes for the people of Oxfordshire. The Agreement extends the approach to integrated commissioning led by the Council on behalf of the partners and will support the further development and implementation of partnership working in Oxfordshire. The Agreement incorporates the Better Care Fund for Oxfordshire.

             iii.         the governance arrangements for the new s75 Agreement

            iv.         that any future development of the s75 Agreement which proposes an expansion of strategic scope, and the relevant budgets may require wider public consultation

The new agreement will commence on 1 April 2023. It has been agreed by the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board at its meeting on 21 March 2023. The new agreement replaces that dating from 1 April 2013 with the former Oxfordshire Clinical Commissioning Group

The s75 agreement gives authority to the Council and the ICB to pool financial and other resources to deliver better outcomes for the people of Oxfordshire. The new agreement extends our approach to integrated commissioning led by the Council on behalf of the partners and will support the further development and implementation of partnership working in Oxfordshire. The agreement incorporates the Better Care Fund for Oxfordshire.

Councillor Bearder introduced the report with the following statement:

‘What is the same and what is different in the new agreement?

• Same: The new agreement has the same scope as the preceding one
  • All age mental health services
  • Services for adults living the learning disability and/or autism
  • Services for adults living with acquired brain injury
  • Services for older people
• Same: The agreement will be managed by the Joint Commissioning Exec Chaired by the DASS reporting to Cabinet and ICB Board, and to Health & Wellbeing Board on the Better Care Fund and Health & Wellbeing strategy performance
• Different: in the new agreement the Council will no longer bear responsibility for some NHS budgets: this has reduced the Council’s £ risk but we retain the ambition to develop integrated care and support
• Different: the agreement is open-ended but can be ended on notice. It will be backed by an Annual Plan agreed by the partners and aligned to the Better Care Fund Plan.

Why is this needed [legal/governance reasons]

• The Council and the ICB are required to have a s75 agreement as part of the Better Care Fund Plan requirements from NHS England
• The Council and the ICB need to have a formal s75 agreement to allow each side to pool resources to jointly commission services to meet the needs of our population: this is the legal vehicle to do this
• The new agreement needs to provide the governance for the Integrated Commissioning function and structure agreed by the Council and the NHS in 2021: it sets out the delegations and the responsibilities of both sides.

Why this is needed [strategic opportunities]

• History: builds on the previous history of s75 agreements between the Council and the NHS. These have supported joint commissioning and joint funding of a variety of services (eg Community mental health services; services for Carers; services for people living with/affected by dementia etc)
• Opportunity is
  • to drive this integrated approach further: to build the care assessment and delivery around the individual and avoid the risk to individuals where people have to “requalify” and be reassessed for services when we know that they will need support from both health and social care at various points in their lives.
  • To create preventative approaches across health and care that reflect the Oxfordshire Way-based on how people live and their own strengths, rather than how we fund and design services. The joint commissioning approach supports this and the s75 enables and authorises the Council and NHS to do that
  • to look across pathways and identify ways to be more efficient. This should lead to better outcomes for our population, and a more efficient use of resources and better value for the Oxfordshire pound.

Development. There is an opportunity to build on partnership work that we are already doing across NHS, district councils, voluntary and community sector (eg around prevention) and over time look at whether more budgets could be built into the pooled arrangement where that makes sense: eg working with Public Health; working with community health services; working with children’s services

Cabinet Member for Adult Social Care AGREED to:

a)    Approve:

               i.         The Agreement of a s75 NHS Act 2006 pooled commissioning budget with Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board from 1 April 2023. The draft Agreement is included in the report as Annex 1.

              ii.         Delegation to Corporate Director of Adult Services and the Council s151 Officer to finalise the Agreement prior to signature in line with the Council’s scheme of delegation.

             iii.         The financial contributions as set out at paragraph 10 and the risk share set out at paragraph 30.

b)    Note:

               i.         The Agreement will commence on 1 April 2023. It has been approved for completion by the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board at its meeting on 21 March 2023. The Agreement replaces that dating from 1 April 2013 with the former Oxfordshire Clinical Commissioning Group.

              ii.         The Agreement gives authority to, and binds, the Council and the ICB to pool financial and other resources to deliver better outcomes for the people of Oxfordshire. The Agreement extends the approach to integrated commissioning led by the Council on behalf of the partners and will support the further development and implementation of partnership working in Oxfordshire. The Agreement incorporates the Better Care Fund for Oxfordshire.

             iii.         The governance arrangements for the new s75 Agreement.

            iv.         That any future development of the s75 Agreement which proposes an expansion of strategic scope, and the relevant budgets may require wider public consultation.