In this week’s note:

  • Better Care Fund in the Spending Review
  • Local Integration Support Fund: updated guidance and Tranche 2 closing date
  • Update on Better Care Fund quarterly reporting
  • Doncaster snapshot published
  • Survey: how local areas are evaluating their Better Care schemes
  • Better Care learning and success-sharing events – sign up now
  • Update on Better Care Insight Visits

Better Care Fund in the Spending Review
As you’ll all be aware, the government published the Spending Review on Wednesday 25 November. The important points relating to the integration of health and social care, including the Better Care Fund, include:

  • The government will continue the Better Care Fund, maintaining the NHS’s mandated contribution in real terms over the Parliament.
  • From 2017, the government will make funding available to local government, worth £1.5 billion in 2019-20, to be included in the Better Care Fund.
  • A commitment of over £500 million by 2019-20 for the Disabled Facilities Grant.
  • The creation of a new social care precept to give local authorities who are responsible for social care the ability to raise new funding to spend exclusively on adult social care. This will allow local authorities the flexibility to raise council tax in their area by up to 2% above the existing threshold, to spend on adult social care.
  • The intention that by 2020 health and social care are integrated across the country. Every part of the country must have a plan for this in 2017, implemented by 2020. The government will not impose how local areas deliver this plan for integration, but the Spending Review sets out a number of different approaches that could be taken.
You can access all the Spending Review documents here. The announcements relating to the BCF provide a clear steer to local areas to make sure you’re planning now for the Better Care Fund in 2016-17, and to work with local partners on the longer term integration of care.
 

We will be working closely with our partners across government to better understand what this means in practice. The NHS Mandate and NHS England planning guidance for 2016-17, due to be published later this month, will provide further detail about the Better Care Fund in 2016-17.

 

Local Integration Support Fund
The first tranche of the Local Integration Support Fund was very popular with bids from 35 areas (with some regional variation) with a total value of £1.6m! It’s great that this type of support has been so well received, and we are expecting a similar level of interest in the second tranche (deadline 11 December). We have therefore doubled the size of the fund to £1m, with over £500k available to areas in the next tranche.

Clearly a number of areas will have been disappointed that they were not successful last time around, so we have produced a summary and guidance explaining our decisions, and to help support and inform bids for the next tranche. This is attached for information here. We would encourage you to share this with regional colleagues, and to work with your Better Care Managers (where in post) to support you in developing your bid.  
 

If you have any further questions, please contact your Better Care Manager or regional NHS and local government leads. Final bids should be submitted by 11 December to your regional Better Care leads, Better Care Managers where they’re in post, or to england.bettercaresupport@nhs.net.

 

Update on Better Care Fund quarterly reporting
Many thanks to the vast majority of local areas for sending in your Q2 Better Care Fund data on time. There are still a few areas who have yet to submit their Q2 data, so please do so as soon as possible. Our analysts will now clean and collate this data to give us a regional and national picture – we may come back with some queries during this process where there is unusual data submitted.

We recently published the Better Care Fund Data Collection and Performance Reports for Quarter 4 2014-15 and Quarter 1 2015-16 on the Better Care Fund page of the NHS England website. You can find this information here - https://www.england.nhs.uk/ourwork/part-rel/transformation-fund/bcf-plan/. We intend to publish the report for Quarter 2 data in the new year.

 

Doncaster Snapshot
We have just published our latest ‘snapshot’ bulletin on the Better Care Exchange. This is part of a series of snapshots where we catch up with local areas on how they are implementing their Better Care Fund. This edition focusses on Doncaster, with a particular emphasis on the ‘Doncaster Academic Partnership’, an innovative relationship between the Council and the two Sheffield Universities. We hope you find this interesting. If you would like to feature in a future ‘snapshot’, please get in touch with Darren.sugg@nhs.net.

 

Survey: how local areas are evaluating their Better Care schemes
In order to improve our support offer, the Better Care Support Team would like to know more about how you are evaluating the impact of your Better Care Fund plan. We know that some localities are doing excellent, innovative work in evaluating their BCF, but the Q1 returns show that others are looking for support. 

We have sent an electronic survey to local contacts for each Health and Wellbeing Board to help identify and share good examples of evaluation. The overall results of the survey will be shared on the Better Care Exchange, and individual examples of good practice will be used to inform our support programme in the new year.

This is the third e-survey we have issued since the summer. The results of the data sharing survey were shared on the Better Care Exchange in October, and have been used in designing a series of information sharing workshops, details of which will be available shortly. The results of a more recent survey – on how patient and service user experience is being used to shape the delivery of care – will be shared before Christmas.

 

Better Care events: learning and sharing success
Don’t miss your chance to sign up for one of the series of regional events to share learning and success across the country. These are being run during February and March 2016, and are an opportunity to share your own learning and successes, including any challenges you’ve overcome, and to learn from others.

These events are free to attend, and open to all those involved in commissioning and delivering integrated services. A list of dates and locations for the events is below – please click on the links to book your place.
 
Tuesday 2nd February 2016, Birmingham https://www.pccevents.co.uk/bettercarebirmingham
Wednesday 3rd February 2016, Leeds  https://www.pccevents.co.uk/bettercareleeds
Thursday 4th February 2016, Manchester https://www.pccevents.co.uk/bettercaremanchester
Tuesday 9th February 2016, Newcastle https://www.pccevents.co.uk/bettercarenewcastle
Wednesday 10th February 2016, Cambridge https://www.pccevents.co.uk/bettercarecambridge
Thursday 11th February 2016, Leicester https://www.pccevents.co.uk/bettercareleicester
Tuesday 23rd February 2016, London https://www.pccevents.co.uk/bettercarelondon
Wednesday 24th February 2016, Gatwick https://www.pccevents.co.uk/bettercaregatwick
Thursday 25th February 2016, Reading https://www.pccevents.co.uk/bettercarereading
Wednesday 2nd March 2016, Wellington https://www.pccevents.co.uk/bettercarewellington
 

If you have any questions regarding these events, please contact the PCC events team: events@pcc-cic.org.uk

Update on Better Care Insight Visits: Luton and the Wirral
In the past fortnight, the Better Care Support Team has visited Luton, Birmingham and the Wirral as part of our Insight Visits programme. The Insight Visits are an opportunity for the national team to understand what local areas are doing well with regards to integrated care, and what national and regional support would be helpful to address their challenges.

 

Luton
In Luton we heard about local progress in developing their primary care model.

This primary care cluster model centres around 31 MDTs that link all core services together, including mental health services. They have been keen to establish effective knowledge sharing across these, forming a specific MDT Best Practice Working Group to ensure this insight is being captured.

Luton are starting to see the dividends of the integrated discharge arrangements they established 18 months ago. Delayed transfers of care are now significantly reduced, but in particular there has been a visible improvement in the strength of relationships between the hospital, council commissioners and the CCG.

Like many areas, Luton have historically been challenged with a particular set of workforce issues. To address these, they and regional partners have established a Workforce Partnership Executive Group in order to develop system-wide workforce plans, and are looking into how they can foster place-based recruitment – so employees aren’t tied to one specific organisation. They have also been using their academic networks to understand how system change models can apply to their context.

Looking forward, Luton have been taking a look at the Shropshire Crisis Care Concordat to understand how this model might work in their system.

 

Wirral
Health and social care partners in the Wirral took an early decision to be courageous, and are using the BCF to fund 13 new services. The local system is managing 25 schemes under their BCF plan, and are making good progress to date.

Schemes tend to focus most strongly on admissions avoidance, and this has had a big impact in a short time: their NEL admissions have fallen further than their initial target of 2.5%. 

In particular, Wirral wanted to share work with us around their mobile nights service that is supporting 580 patients with overnight domiciliary reablement care. We also heard about good work to establish a single front door at the acute trust, their work with SRNA to develop interoperability, and new street triage services in operation.

The BCF has had other helpful effects in the area – the BCF laid the groundwork in building mutually strong and collaborative relationships, leading to the development of their Vanguard initiative, Healthy Wirral.

Wirral continue to have a high level of ambition locally, and their next steps are to scale up their rapid community response, and to work on exploiting technological innovations.

 

This week
This week we’ll be visiting Sheffield and Southampton, and will include summaries of those as well as our recent visit to Birmingham in the next update note. If you’d like any more information on the visits, please get in touch with Dan.Gocke@nhs.net


Anthony Kealy

Anthony Kealy

Better Care Support Team Programme Director