Agenda and minutes

Health and Wellbeing Board Commissioning Sub-Committee
Tuesday, 13th October, 2015 2.00 pm

Venue: LH 2.32 - Loxley House, Station Street, Nottingham, NG2 3NG. View directions

Contact: Phil Wye 

Items
No. Item

17.

Apologies for absence

Minutes:

Councillor Alex Norris

Candida Brudenell

18.

Declarations of interest

Minutes:

None

19.

Minutes of the last meeting pdf icon PDF 18 KB

Minutes of the last meeting held on 8 September 2015 (for confirmation)

Minutes:

The minutes of the meeting held on 8 September 2015 were confirmed and signed by the Chair.

20.

Better Care Fund Quarter 2 Budget Monitoring Report pdf icon PDF 240 KB

Joint report of the Director of Finance and the Corporate Director for Children and Adults

Minutes:

Darren Revill, Finance Analyst, presented the joint report of the Director of Finance and the Corporate Director for Children and Adults, summarising the second quarter Better Care Fund (BCF) Monitoring Report  and updating the Commissioning Sub-Committee on the pay for performance element of the fund.

 

There is a forecasted underspend in 2015/16 of £2.348 million. Applying the agreed approach to meet any pay for performance shortfall from underspends within the pooled fund, this figure is reduced to £1.834 million.

 

RESOLVED to

 

(1)  note the cash flow position of the BCF Pooled Fund as at Quarter 2 of 2015/16:

 

Cash Flow at end of Quarter 2

Funding into Pool:

 

CCG Baseline (Minimum Contribution)

£10,711,000

Other CCG Allocation

£916,000

NEL Adjustment

£153,000

CCG Sub-Total

£11,474,000

Disabled Facilities Grant

£507,000

Social Care Capital Grant

£432,000

Social Care Contribution

£358,000

City Council Sub-Total

£1,296,000

Total Income

£12,770,000

 

 

Funding out of Pool:

 

CCG

£4,916,000

City Council

£6,772,000

Total Expenditure

£11,688,000

 

 

Fund Balance

£1,082,000

 

(2)  note the forecast position of the BCF Pooled Budget as at Quarter 2 of 2015/16 as an underspend of £1.834 million;

(3)  note the updated position in relation to the Pay for Performance element of the fund:

 

BCF Period

Measurement Period

NEL Target

Value of Pay for Performance

Achieved

Shortfall

Quarter 1

January to March 2015

-3.5%

£361,000

£208,000

£153,000

Quarter 2

April to June 2015

-1.6%

£184,000

£184,000

£0

Quarter 3

July to September 2015

-1.6%

£180,000

 

 

Quarter 4

October to December

-1.6%

£180,000

 

 

Total

 

 

£905,000

£392,000

£153,000

 

 

 

21.

Better Care Fund (BCF) 15-16 Underspend Proposals pdf icon PDF 314 KB

Report of the Corporate Director for Children and Adults

Minutes:

Antony Dixon, Strategic Commissioning Manager, presented the report of the Corporate Director for Children and Adults, updating the Sub-Committee on proposals for utilisation of the Better Care Fund (BCF) underspend which will support the delivery of BCF metrics, support further integration of Health and Social Care provision in the city and improve outcomes for vulnerable older citizens and those with long-term conditions.

 

Antony highlighted the following:

 

(a)  a substantial in-year underspend of the BCF pooled budget against agreed funding has been identified, predominantly due to delay in implementing seven day service provision;

(b)  eight proposals have been made in order to ensure continued delivery against BCF metrics and improve citizen outcomes. These are all short-term measures that require funding in-year;

(c)  the first proposal is for a contingency fund to mitigate against any failure to deliver pay for performance targets. As guidance in relation to future pay for performance elements of the BCF is not yet available, if there is no future pay for performance element of the BCF this will be released back into the underspend;

 

The following answers were given in response to questions from the Sub-Committee:

 

(d)  the minimum wage uplift will raise the hourly rate of Care at Home Framework providers earlier than the original intention of April 2016. This will assist in recruiting new workers in an increasingly competitive area;

(e)  the proposals for reducing unnecessary delays were clarified. This is a proposal to apply mental health principles to the care of physical health patients, in particular post-operative period to reduce length of stay. The Sub-Committee felt that the language used for this was subjective and could be improved;

(f)  the outcomes from the pilots will be reported back at different times depending on their timescales;

(g)  the full contract value of the proposal for Care at Home Framework 24 Hour Pick Up is £201,541, however the estimated cost to the pooled fund is £85,153.

 

RESOLVED to

 

(1)  approve proposals for utilisation of 2015/16 BCF underspend and approve spend to the value of £1,013,906 as detailed below:

 

Proposal

Value of proposal

Contingency fund for 2016/17 Pay for Performance

£400,000

Care at Home Framework – Winter Wage Uplift

£140,000

Reducing unnecessary delays

£37,850

Care at Home Framework – 24 hour pick up

£201,541

Care at Home reviewer pilot

£68,814

Community Navigator pilot

£35,000

Extension of Nottingham Health and Care Point

£94,820

Extension of Urgent Care Interim Homecare

£35,881

Total

£1,013,906

 

(2)  approve dispensation from section 5.1.1 of the council’s contract procedure rules in accordance with section 3.29 of the council’s financial regulations in relation to the award of contracts for 24 hour Care at Home urgent pick up pilots to Nottingham City Council Care Bureau;

(3)  approve dispensation from section 5.1.1 of the council’s contract procedure rules in accordance with section 3.29 of the council’s financial regulations in relation to the extension of a contract for the Community Navigator pilot to Bestwood Directions;

(4)  approve carry forward of BCF underspend to meet the cost of these proposals, currently estimated at £537,000.

22.

Exclusion of the Public

To consider excluding the public from the meeting during consideration of the remaining item in accordance with section 110a(4) 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.

Minutes:

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 a basis that, having regard to all the circumstances, the public interest in maintaining the exemption outweighed the public interest in disclosing the information.

23.

Better Care Fund (BCF) 15-16 Underspend Proposals - Procurement and Legal comments

Minutes:

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