Better Care Fund

1. Better Care Fund David Bunce, Gateshead Council Dan Cowie, Gateshead CCG Gateshead Health & Wellbeing Board: 7 February 2014

2. Better Care Fund – Recap What is it? • Asingle pooled budget for health and social care • To enable health and social care services to work more closely together in local areas • Based on a plan agreed between the NHS and local authorities • Is part of NHS 2 year (operational) and 5 year (strategic) plans Size of Fund? • £3.8 billion nationally, Gateshead allocated £5.194m (2014/15) and £17.214m (2015/16) • However: - Not new money: Fund draws on money already in the system - Fund is performance linked: around £4.53m of 2015/16 allocation

3. Better Care Fund – Finances Overall requirement for the Better Care Fund in Gateshead for 2015/16 is £17.2m, broken down as follows:

4. Better Care Fund – Finances Current areas of expenditure that have been mapped across to the BCF requirement are as follows:

5. Better Care Fund – Requirements Six national conditions need to be met: • Plans to be jointly agreed; • Protection for social care services (not spending); • 7-day working in health and social care to support patients being discharged and prevent unnecessary admissions at weekends (as part of agreed local plans); • Better data sharing between health and social care; • Ensure a joint approach to assessments and care planning and an accountable professional for integrated packages of care; • Agreement on the impact of changes in the acute sector.

6. Better Care Fund – Requirements National Measures: • admissions to residential and care homes • effectiveness of reablement • delayed transfers of care • avoidable emergency admissions • patient/service user experience PLUS One local measure – Proposed measure: • Dementia – estimated diagnosis rate for people with dementia

7. Better Care Fund – Requirements Submission deadlines to government: 14 Feb – Draft Submission Deadline 4 April – Final Submission Deadline (Note – same deadlines for submission by NHS organisations of their 2 year operational plans. Also, needs to be aligned with provider plans)

8. Our approach in Gateshead • ABCF steering group has been established to oversee work. It feeds into our Health & Wellbeing Board • Workstreams around key issues e.g. engagement (providers and service users/public), data sharing, finance, joint assessments, 7 day services, outcomes/measures, risks, implications for the acute sector and governance • Key issue - meet the submission requirements of the BCF for 2014/15 and 2015/16 whilst also pursuing a longer term conversation around the future direction of services to deliver integrated care in Gateshead • Not starting from a blank sheet of paper – building upon our Health and Wellbeing Strategy, our Pioneer bid and other work

9. Our Progress to-date • A ‘shared view’ of future direction • Plan on a Page for BCF developed • Population group broadly defined • Workstreams are addressing submission requirements • An initial draft template has been completed • Engagement with public/patient/service users • Engagement with provider organisations

10. Better Care Plan – ‘Our Shared View’ A 'CARE' service: Community-based (within locality), Aligned (health + social care), Responsive and Empowering for all users.

11. ‘Our Shared View’ C A R E It will require a shift from an ‘acute centred’ to a ‘preventative’ model. It will see care provided for the whole person, ‘not the person’s parts’. It will have a long term focus on ‘continuity’ of care.

12. Outcomes – Patient & Service Users • ‘I want to go home from hospital as soon as I am ready, on any day of the week.’ • ‘I can remain in my home with help and support for as long as I am happy.’ • ‘When my chest is bad I have my antibiotics in a drip at home.’ • ‘Following my stroke I have support to remain healthy and independent at home.’ • ‘I feel safe, valued, respected, and listened to by all those who deliver my care’. • ‘I am in control of my care and can get support when needed.’ • ‘I am part of a community and have the support I need.’

13. Better Care Fund - Plan on a Page • Insert plan (copies to be available)

14. Better Care Fund Plan – ‘Our Model’

15. 5 Strategic Enablers • Joint Commissioning for Intermediate Care and Care Home Services • Alignment of 5 Locality Based Population areas • Aligned Health and Social Care Planning Processes • Implementation of Joint IT System • A New Funding Environment

16. BCF Schemes & Initiatives • Single Point of Access • Alignment of District Nursing, Community Matrons, and Older People Nurse Specialists and RICC nurses + GP frailty register • Elderly Care ‘coordinator role’ + alignment of frailty teams • Expansion of Ambulatory (avoidable) Emergency Conditions (AEC) pathways • Establish a 24/7, seamless palliative care service • Establish an Urgent Domiciliary Support Service • Establish a seamless falls service • Expansion of the Gateshead Care Home Initiative

17. BCF Schemes & Initiatives (continued) • Expansion of intermediate care services • Alignment of discharge support teams + ‘Coordination officers’ • Establish a seamless dementia pathway across Gateshead

18. Phases towards Implementation • Preparation Phase – to April 2014 • Work-up Phase towards full implementation – April to September 2014 • Full Implementation Phase – September 2014 onward

19. Better Care Fund Plan – Next Steps • Workstreams to progress submission requirements • Submit draft plan to Government by 14 Feb • Final BCF Plan to HWB special meeting on 31 March • Plans also to be approved by GCCG and Council • Submit Final Plan by 4 April

20. Any Questions or Comments