The Better Care Fund in Kingston 1/3 1. What is the Better Care Fund (BCF) 2. About the Better Care Fund Plan • Formerly termed the Integration Transformation Fund (ITF) • A 2 year BCF Plan (incorporating completed national templates) • Substantial local pooled budget to be established in 2015/16 is required. • 1 st draft by 14 th February 2014, final version by 4 th April 2014. to take the integration agenda forward at scale and pace, • The BCF Plan needs to be signed off by the Health and acting as a significant catalyst for change • The Fund will be used to drive closer integration and improve Wellbeing Board, including agreement to the level of ambition outcomes for patients, service users and carers. expressed in the performance measures. • The aim is to provide people with right care, in the right place, • The HWB will consider whether the Plan is sufficiently at the right time, including through significant expansion of challenging and whether it will deliver tangible benefits for the care in community settings. local population. 3. About the Better Care Fund Expected BCF allocations National Kingston £m £m £000 £000 • Legally the Fund commences in 2015/16 as a pooled budget under 14/15 15/16 14/15 15/16 Section 75 joint governance arrangements between the CCG and Existing transfer from health to adult 1100 1100 2627 2627 Local Authority. social care • 2014/15 is regarded as a preparatory year when the planned Carers’ breaks funding 130 140 transfer of funds from health to adult social care will be increased CCG reablement funding 300 932 from £900m to £1.1bn nationally. • Capital funding (including Disabled 354 859 The additional £200m will only be paid to Local Authorities which Facilities Grant) + have jointly agreed and signed off a 2 year BCF Plan (estimated as £478k of the £2627k in Kingston). Additional transfer from health to 1900 6183 • These funds must be used ‘to support adult social care services … adult social care which also have a health benefit’. Councils should use the Totals 1100 3800* 2627 10741 additional £200m to prepare for the implementation of pooled budgets in 2015/16 and make early progress against the relevant + = contribution from adult social care budgets. Remainder from CCG allocations in 2015/16 BCF national conditions and performance measures. * = aggregate allowing for rounding etc PC, 3/1/14
The Better Care Fund in Kingston 2/3 4. National Conditions 5. Performance Measures • All the funds included in the BCF in 2015/16 will be • Initially a limited number of national measures for the BCF have been contingent on meeting the national conditions set out identified because of the need to use existing measures to establish in the spending review settlement in July 2013: baseline performance in 2014/15: a) A plan that is signed off by the Council, its Health and a) admissions to residential and nursing homes; Wellbeing Board and the constituent Clinical b) effectiveness of reablement; Commissioning Groups with demonstrable c) delayed transfers of care; engagement of providers; d) avoidable emergency admissions; and b) Protection of social care services evidenced by e) patient / service user experience. sustaining eligibility; f) In addition local areas will choose 1 further local indicator for which it c) Data sharing between health and social care using must be possible to establish a baseline in 2014/15. the NHS number as a unique identifier; d) 7 day working in social care to enable hospital 6. Payment-for-performance element discharge and reablement; • Nationally £1bn of the £3.8bn in 2015/16 will be linked to achieving e) Joint assessment arrangements between health and outcomes, half to be released in April 2015, the balance on October social care to enable a single assessment and a single 2015 based on the following: accountable professional; f) A clear statement of the implications of the When Payment for Paid for: proposed use of the BCF for hospital providers that performance amount are affected that is signed off by the health and well- (nationally) being board; and Progress against 4 of the national £250m g) A risk assessment of the consequences of failing to conditions, section 4 b, d, e, f above April 2015 achieve proposed changes in activity levels and a Progress against the local metric and 2 plan to mitigate these. £250m of the national metrics, section 5 c, d, f above Further progress against all of the Oct 2015 £500m national and local measures • Note in 2015/16 failure to deliver BCF performance targets will NOT result in withholding of the payment for performance. Other requirements / sanctions may be applied e.g. production and agreement of a local recovery plan. PC, 3/1/14
The Better Care Fund in Kingston 3/3 – Summary of Progress in Kingston • Initial guidance around Integration Transformation Fund August 2013 (now renamed Better Care Fund) shared widely and discussed with stakeholders • Initial Integration workshop held October 2013 – wide participation: statutory, voluntary, commissioner, provider, patient representatives • Health and Wellbeing Board leadership role for local integration agenda established • PPL Consultants retained to assist with development of BCF (experience elsewhere across London and at National level) • BCF initial co-design workshop held December 2013, building on October workshop • BCF guidance and CCG financial allocations 14/15 -15/16 received 20 th December 2013 including specification of minimum level of Fund in 2015/16 • Dec workshop informing development of 1 st draft BCF Plan, for discussion early January 2014 and focus for 2 nd co-design workshop late January 2014 • Revised draft BCF to Health and Wellbeing Board 4 th Feb 2014 • Agreed draft BCF incorporated into CCG draft Operational Plan for submission by 14 th February 2014
NHS Planning 2014/15 and beyond – summary of national requirements Vision: High quality care for all, now and for future generations NHS Outcomes Framework - 5 Domains CCG Planning: National Requirements - 6 broad ‘Themes’, 24 ‘Fundamental Areas’: 1. Prevent people from dying prematurely 1. Outcomes 4. Quality 2. enhancing quality of life • 5 NHS Outcomes Framework Domains, 7 NHS Outcome • Francis, Berwick, 3. recover quickly and successfully Ambitions Winterbourne View 4. positive experience of care • Improving health • Patient safety 5. safe, protected from avoidable harm • Reducing health inequalities • Patient experience • Parity of esteem • Compassion in practice • Staff satisfaction 2. Patient Services / delivering transformational service • 7 day services models NHS 7 Outcome Ambitions – 5 Years • Citizen involvement, patient empowerment • Safeguarding 1. Securing additional years of life for the • Wider primary care provided at scale 5. Innovation people of England with treatable mental and • A modern model of integrated care • Research and innovation physical health conditions. • Access to highest quality urgent and emergency care 6. Delivering Value 2. Improving the health related quality of life of • Step-change in productivity of elective care • Value for money the 15 million+ people with one or more long- • Specialised services concentrated in centres of • Effectiveness term condition, including mental health • Efficiency excellence conditions. • Procurement 3. Access 3. Reducing the amount of time people spend • Convenient for everyone avoidably in hospital through better and more • NHS Constitution pledges integrated care in the community, outside of hospital. 47 ‘Key Features’ and a range of Performance Measures associated with above 4. Increasing the proportion of older people living independently at home following discharge from hospital. 5 Years, SW London level, 1 st draft 4/4/14, Final 20/6/14 Strategic Plan 5. Increasing the number of people with mental and physical health conditions having a positive Operational Plan 2 Years, CCG level, 1 st draft 14/2/14, Final 4/4/14 experience of hospital care. Kingston working towards Joint Operational Plan across CCG, 6. Increasing the number of people with mental Adult Social Care, Public Health and physical health conditions having a positive experience of care outside hospital, in general Better Care Fund Plan 2 Years, HWB level, within CCG Operational Plan and timetable practice and in the community. 7. Making significant progress towards Financial Plan 2 Years, CCG level, detailed financial breakdown of each Plan eliminating avoidable deaths in our hospitals (Strategic, Operational Better Care Fund) caused by problems in care.
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