Agenda and minutes

Katy Ball (Nottingham City Council)

Colin Monckton (Nottingham City Council)

Jo Williams (Clinical Commissioning Group)

None

RESOLVED to

1)  appoint Candida Brudenell, Nottingham City Council’s Strategic Director for Early Intervention, as Chair for the meeting.

2)  note that the Chair will rotate between Candida Brudenell and Maria Principe, Director of Primary Care and Service Integration (Clinical Commissioning Group) on a meeting by meeting basis in accordance with the Terms of Reference for the Sub-Committee.

Report of the Director of Primary Care Development and Service Integration and the Director of Quality and Commissioning

Antony Dixon, Strategic Commissioning Manager, Nottingham City Council presented the joint report of the Director of Primary Care Development and Service Integration and the Director of Quality and Commissioning  which provided information on the performance of the Better Care Fund (BCF) against agreed national and local metrics.

Antony highlighted the following points to the Sub-Committee:

a)  The BCF provides funding to be spent on health and care services to drive closer integration and improve outcomes. BCF performance is measured against four national metrics:

·  reductions in non-elective admissions to hospital,

·  reductions in delayed transfers of care,

·  reductions in permanent residential admissions,

·  increased effectiveness of reablement,

and two local metrics:

·  improvement in citizen outcomes,

·  increased uptake of assistive technology.

b)  There is a pay for performance element which relates only to the target for the reduction in non-elective activity and 61% of the pay for performance payment (£220,520) was achieved during quarter four. This is against a target of a 3.5% reduction which was not met but has already been revised to take into account actual performance levels. The Health and Wellbeing Board agreed a revised target of 1.6% reduction and, although discussions are still ongoing with NHS England, current understanding is that quarter one performance will be measured against the revised target. Based upon performance for the first month of quarter one, the revised target will be met.

c)  There was an over-performance against the residential admissions target with 146 permanent admissions to residential care against a target of 242. However there is concern about the data quality for this target and concern that there may have been under-reporting during 2014/15. Further analysis and revisions of business processes are underway.

d)  There was an over-performance against the assistive technology target with 4809 users against as target of 4800.

e)  The reablement target is under-performing but there are recording issues related to this target which are being addressed.

f)  The data quality issues are not unique to Nottingham.

RESOLVED to

1)  note the current performance in relation to BCF metrics.

2)  agree that future reports on BCF performance will identify highlights and lowlights but will not contain the level of detail of this report.

Report of the Chief Finance Officer and the Corporate Director for Children and Adults

Darren Revill, Finance Analyst, Nottingham City Council, introduced the report of the Corporate Director for Children and Adults which detailed the quarter one performance against the Better Care Fund (BCF) budget. The report highlighted:

a)  an underspend, currently forecast at £1.235m for 2015/16 against the co-ordinated care area of spend and attributable to the seven day working allocation. Further reports will be brought to this sub-committee to approve the services supported by this workstream.

b)  The adjustment of the budget to reflect the finalisation of contracts with service providers.

c)  The non-achievement of part of the pay for performance payment related to the non-elective admissions target.

RESOLVED to

1)  approve the realignment of NHS Nottingham City Clinical Commissioning group (CCG) schemes to reflect 2015/16 finalised contract values.

2)  approve the allocation of £0.176m released from the realigned budget to fund Ramsay Wait Beds to support discharges from Nottingham University Hospital in 2015/16 while further care arrangements are made.

3)  note the projected position of the BCF Pooled budget as at Quarter 1 of 2015/16.

4)  approve the use of underspends in 2015/16 to meet the non-achievement of the Pay for Performance element of funding within the BCF in accordance with the Section 75 Partnership Agreement.

Report of the Corporate Director for Children and Adults

Antony Dixon, Strategic Commissioning Manager, Nottingham City Council introduced the report of the Corporate Director of Children and Adults which requested approval for the use of Social Care Capital Grant (now contained within the Better Care Fund) to meet capital costs associated with work seeking to reduce non-elective acute and residential care admissions.

The report requested funding for the following purposes:

a)  £400,000 as a contribution to the capital costs associated with the delivery of the Integrated Community Equipment Loan Service (ICELS) as spend in this area has exceeded original estimates for 2015/16

b)  £322,000 for the capped cost system and a further £141,000 for additional financial modules related to Project Evolution which supports the adult social care department’s ability to cope with additional demand on services.

Antony confirmed that the funding was part of the City Council’s budget so the additional funding would not affect health budgets and that the sub-committee was being asked to approve how the money was being spent.

RESOLVED to approve the allocation and spend of £863,000 of Social Care Capital grant for the purposes outlined above.

Report of the Corporate Director for Children and Adults

Nicky Dawson, Priority Families Programme Co-ordinator, Nottingham City Council, introduced the report which requested £24,000 from the Troubled Families grant funding to be distributed amongst 16 frontline practitioners. The funding will be used by the practitioners to provide support for families they are working with to help pay for practical items that could not be budgeted from elsewhere, for example purchasing replacement birth certificates to enable apprentices to register for employment.

The funding was being allocated to the 16 practitioners rather than managed centrally to provide a budget management development opportunity for the practitioners.

RESOLVED to

a)  approve the release of £24,000 from the troubled families grant funding for one year as a small Family Resource Budget, to be divided into 16 £1500 shares each share managed by a frontline practitioner and to be spent in support of the families they are working with.

b)  note the delegated authority from the Health and Wellbeing Board to the Priority Families Leadership group to oversee and manage the Priority Families partnership budget and to bring forward recommendations for use of programme resource and grant funding for final decisions by this sub-committee.

Report of the Corporate Director for Children and Adults and the Strategic Director for Early Intervention

Christine Oliver, Head of Service, Finance and Commissioning, Nottingham City Crime & Drugs Partnership introduced the report which sought authority to implement a more joined up approach to commissioning domestic and sexual violence services as recommended by the Safe From Harm review. Christine provided the following information to the sub-committee:

a)  In order to achieve a more joined up approach to commissioning it is proposed to pool the Police and Crime Commissioner (PCC), Clinical Commissioning Group (CCG) and Nottingham City Council (NCC) budgets and award all contracts relating to Domestic and Sexual Violence Services from this single budget.

b)  New five year contracts will be procured offering stability for providers.

c)  All procurement decisions will be taken in line with NCC’s Financial Regulations and Contract Procedure Rules.

RESOLVED, as outlined in exempt appendices 1 and 2, to

1)  Agree the transfer and spend of PCC and CCG additional funding for additional projects;

2)  Authorize the procurement of new domestic and sexual violence contracts;

3)  Agree 5 year contracts for new domestic and sexual violence contracts;

4)  Delegate authority to the Strategic Director for Early Intervention to sign contracts arising from the tender process, following assessment by the Joint Commissioning Group of tenders received, and in line with the Group’s recommendations on the outcome of the tender process;

5)  Approve dispensation from financial regulation 3.29 under agreed corporate contract procedure rule 5.1.2 in respect of those contracts identified in the exempt appendices.

To consider meeting at 3.00pm on the following Tuesdays:

2015: 8 September, 10 November

2016: 12 January, 15 March

RESOLVED to approve the following dates of future meetings but that the time of the meeting be consulted upon and confirmed to the sub-committee:

8 September 2015, 10 November 2015, 12 January 2016, and 15 March 2016.

To consider excluding the public from the meeting during consideration of the remaining item(s) in accordance with section 100a(3) of the Local Government Act 1972 on the basis that, having regard to all the circumstances, the public interest in maintaining the exemption outweighs the public interest in disclosing the information.

RESOLVED to exclude the public from the meeting during consideration of the remaining item in accordance with section 100a(4) of the Local Government Act 1972 on the basis that, having regard to all the circumstances, the public interest in maintaining the exemption outweighed the public interest in disclosing the information.

The sub-committee noted the information in the exempt appendices.