Better Care Fund
John Webster – Director of Commissioning
Chris Badger – Assistant Director – Health and
Social Care Integration
Recap - What is the Better Care
Fund?
“The Better Care Fund is a single pooled budget to support
health and social care services to work more closely
together in local areas.”
“It provided an opportunity to transform local services so that
people are provided with better integrated care and
support.”
“The Fund will support the aim of providing people with the
right care, in the right place, at the right time, including
through a significant expansion of care in community
settings.”
NHS Planning Guidance, December 2013
Make up of fund nationally
2015/2016 (billions)
NHS Funding
0.13
0.354
0.3
1.9
Existing NHS monies
allocated to social care
Carers Breaks
1.1
Reablement funding
£200m of this is
new monies
allocated in
2014/15, paid on
condition of BCF
N.B. this is minimum that
can be pooled
Capital funding (incl.
DFG)
National
ENCCG
HVCCG
C and P CCG
TOTAL
BCF
contribution to
social care from
NHS 2014/15
£1.1bn
£9.06m
£9.59m
£0.30m
£18.95m
(of which new
monies in
2014/15)
£200m
£1.99m
£2.10m
0.06m
£4.15m
Existing NHS
funds*
£2.68bn
£22.36
£23.58m
£0.72m
£46.66m
Total 2015/16
£3.8bn
£31.43m
£33.16m
£1.02m
£65.61m
The Proposed Pool
Commissioning Area
ENCCG
(£’000)
ENCCG COMMISSIONING AREAS AND SPEND
Existing CCG allocations to social care
9, 063
Hertfordshire Community Trust services for older people
21,420
Other intermediate care
2,198
Continuing Care
13,506
Carers
272
Other
4,938
Total
51,397
HERTFORDSHIRE COUNTY COUNCIL COMMISSIONING AREAS AND SPEND
Assessment and Care Management
5, 334
Residential and Nursing
36, 508
Community Services
15, 847
Direct Payments
1, 968
Flexicare Housing
2, 993
Other Older peoples
874
DFG Allocation 201516
1,588
Social care capital
1,151
Total
TOTAL BETTER CARE FUND FOR EAST AND NORTH HERTFORDSHIRE
66,262
117,659
Enhanced ENHCCG role commissioning key
social care services
• Residential budget £36.5m
-Focus on quality, Carehome premium and link to Enhanced Primary Care
Support to patients in care homes
-Enablement bed provision
• Homecare provision – £15.8m including full review of homecare contracts
in 2014/14
-Discharge to Assess and ‘Home from Hospital’ homecare
-Enablement care
-Rapid response homecare to support HomeFirst
-Dementia and End of Life
ALL OF THE ABOVE CENTRAL TO HELPING PEOPLE BE INDEPENDENT
AND MANAGING ACUTE PRESSURES
Joint commissioning to deliver
outcomes
Better Care PlanHealth and WellBeing Board
Integrated Working
Better Care
Fund
Joint
Commissioning
National
and local
metrics
National
conditions
JOINT COMMISSIONING STRUCTURES WITH KEY ROLE FOR PROGRAMME
BOARDS
Joint engagement events to seek views on BCF
priorities for integration
(214 attendees, 86 organisations)
•
•
•
•
Joined-up, coordinated care between statutory
services, voluntary and community groups, and
individuals, their families and carers
Communication of and between services helping
to support individuals in their choice of care
Prevention and self-management to preserve
good health and wellbeing
Rapid access to community services
Emerging vision for integration
1. Services work together to maximise the
independence of people in Hertfordshire
2. Effective integrated community services
built around primary care
3. Jointly commission services around
individuals and their needs
4. An integrated workforce, appropriately
skilled and able to work across
organisational boundaries
Objectives
• Improved life expectancy at 75 with narrowing
variation across the County
• Reduce admissions of 65 and overs to acute care and
maintain people’s independence for as long as
possible
• People are re-abled and rehabilitated as effectively
and quickly as possible after a crisis or exacerbation
• People die in their place of choice
Objectives continued
• There is quality care for people with dementia
• Stroke patients receive timely and quality
acute care, and their rehabilitation potential is
maximised
National metrics
Admissions
to residential
and care
homes
Patient /
service user
Avoidable
emergency
experience
admissions
Delayed
Effectiveness
of
transfers of
reablement
care
Next Steps
• Develop joint governance and joint
commissioning structures for Better Care
Fund
• Develop joint programme to deliver
integration
• Early work to get momentum
- Stroke pathway
- HomeFirst
- Intermediate care