To note that Dr Marcus Bicknell has been appointed to replace Dr Ian Trimble as the GP Lead for NHS Nottingham City Clinical Commissioning Group on the Committee.

RESOLVED to note that Dr Marcus Bicknell had been appointed to replace Dr Ian Trimble as the GP Lead for NHS Nottingham City Clinical Commissioning Group on the Committee.

Candida Brudenell

Maria Principe

Alison Challenger

None

To confirm the minutes of the meeting held on 18 May 2016

The minutes of the meeting held on 18 May 2016 were confirmed as an accurate record and signed by the Chair.

To agree to meet on the following Wednesdays at 3pm:

·  14 September 2016

·  14 December 2016

·  8 March 2017

RESOLVED to meet on the following Wednesdays at 3pm:

·  14 September 2016

·  14 December 2016

·  8 March 2017

Jo Williams, Assistant Director Health and Social Care Integration, introduced the report outlining performance in relation to the Better Care Fund performance metrics for the period Quarter 4 2015/16.  She highlighted the following information:

a)  The target for avoiding permanent residential admissions was not met.  A deep dive review to identify the reasons for this and action that can be taken will be carried out and this should lead to improved performance going forward.

b)  Performance against the metric for increased effectiveness of reablement has improved.  The target is now consistently being met and stretch targets have been set for next year as it is felt that there is potential for more to be achieved.

c)  Delayed transfers of care continue to be a problem.  The number of delayed days continues to increase and it is also a problem in the County.  A deep dive analysis into the reasons for this is being carried out to better understand the issues and the future focus will be on producing and implementing an action plan to address these issues.

d)  Local metrics to increase uptake of assistive technology and improve health and social care outcomes are both on target.

e)  A survey to key stakeholders seeking feedback on the first year of implementation of the Better Care Fund has been undertaken and the findings will be reported to a future meeting of the Sub-Committee.

In response to a question Jo Williams advised that recent regional discussions have focused on integration initiatives rather than performance but that a regional breakdown of end of year performance will be circulated when it is available.

RESOLVED to:

(1)  note the performance in relation to the Better Care Fund performance metrics as detailed in paragraph 2.4 of the report; and

(2)  note the Better Care Fund Quarter 4 outturn submitted to NHS England on 27 May 2016.

Darren Revill, Finance Analyst, introduced the report outlining the pre-audit 2015/16 Better Care Fund outturn and the fund balance and commitments as at 31 March 2016.  He highlighted the following information:

a)  In terms of cash flow the only variation relates to non-elective admissions.  The Quarter 1 element was not met and therefore Nottingham City Clinical Commissioning Group withheld money from the Pooled Fund. 

b)  The cash flow position at the year-end was £2,324,000.

c)  The outturn statement shows the breakdown by area of spend.  The biggest area of spend was Co-ordinated Care.

d)  Out of the outturn position of £2,324,000 there were approved funding commitments of £1,879,000.  The fund balance after commitments was £445,000 which will be carried forward.

e)  Other than the target for non-elective admissions not being met in Quarter 1 the Pay for Performance elements were achieved and a balance of £153,000 has been retained.

f)  The Council’s final Statement of Accounts including the Pooled Fund Memorandum Account will be considered by the Council’s Audit Committee in September 2016 following completion of the external audit.

RESOLVED to:

(1)  note the cash flow position of the Better Care Fund Pooled Fund as at 31 March 2016 as set out in table 1 of the report;

(2)  note the outturn position of the Better Care Fund Pooled Fund as at 31 March 2016 as set out in table 2 of the report and approved funding commitments against this balance; and

(3)  note the final position of the Pay for Performance element of the Fund as set out in table 3 of the report.

Jo Williams, Assistant Director Health and Social Care Integration introduced the report setting out proposals for the utilisation of the 2016/17 Better Care Fund in relation to the carry forward of money from the 2015/16 Better Care Fund and anticipated in-year underutilisation.  She highlighted the following information:

a)  The three proposals – Click Nottingham; expansion of the Temporary Assessment Project Team; and Citizen Triage Point - all support delivery of Better Care Fund metrics.

b)  While an evaluation of Click Nottingham is undertaken it is proposed that commissioning of the service transfer from Nottingham City Clinical Commissioning Group to Nottingham City Council.

c)  Some of the proposals have recurrent funding requirements and some are non-recurrent.

RESOLVED to

(1)  approve proposals for utilisation of the Better Care Fund underspend as detailed in the exempt appendix 1 and approve spend for this purpose totalling £492,469;

(2)  approve dispensation from Contract Procedure Rule 5.1.2 in accordance with Financial Regulation (3.29)(Operational Reasons) in order to make a direct award to Click Nottingham for 6 months from July 2016 to December 2016 with the potential to extend for a further 3 months to 31 March 2017 subject to the outcome of the review and available funding; and

(3)  delegate authority for signing the Click Nottingham contract to the Head of Contracting and Procurement.

To consider excluding 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 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 outweighs the public interest in disclosing the information.

The Committee considered the exempt appendices to the Better Care Fund Underspend Proposals July 2016 report.

RESOLVED to note the information contained within the exempt appendices.