Agenda and minutes

·  Councillor Adele Williams has joined the Committee as a new member, following an update to the Committee’s Terms of Reference.

·  Sarah Fleming has replaced Andrea Brown as a representative of the Greater Nottingham Clinical Commissioning Partnership.

The Committee noted that Councillor Adele Williams has joined the Committee as a new member, and that Sarah Fleming has replaced Andrea Brown as a representative of the Greater Nottingham Clinical Commissioning Partnership.

Alison Challenger  -  work commitments

Catherine Underwood  -  work commitments

Councillor Adele Williams  -  personal reasons

None.

Minutes of the meeting held on 29 May 2019, for confirmation

The Committee confirmed the minutes of the meeting held on 29 May 2019 as a correct record and they were signed by the Chair.

Approved by the Health and Wellbeing Board on 29 September 2019

The Committee noted its updated Terms of Reference.

Report of the Head of Joint Commissioning, Greater Nottingham Clinical Commissioning Partnership

Bobby Lowen, Commissioning Lead, and Naomi Robison, Senior Joint Commissioning Manager at NHS Nottingham City CCG, presented a report on the 2019/20 Nottingham City Better Care Fund (BCF) Plan for review and agreement, which sets out the programme areas, activity, finance and performance metrics against the 2019/20 national BCF allocation and planning guidance. The following points were discussed:

(a)  the guidance describes 2019/20 as a year of minimal change. As such, the planned programme areas remain the same for 2019/20 as they were in 2018/19, and the schemes continue to evolve and benefit from leadership support at both an Integrated Care System and Health and Wellbeing Board level. The financial plan has been updated to reflect the national minimum contribution, which includes a 2019/20 mandated uplift of 5.2%, which is higher than the initial indication of 1.79%. This has been proportioned across the existing schemes to support contractual staffing pressures, with the remaining uplift being used for additional home care hours;

(b)  the four national BCF metrics are non-elective admissions, admissions to residential and care homes, effectiveness of reablement, and delayed transfers of care. The BCF Plan narrative highlights the contribution of a number of individual schemes to achieving these metrics. The Plan was submitted to the National BCF Team on 27 September 2019 for and assurance review by the Midlands BCF moderation panel, and the panel’s recommendation is to approve the Plan. Final confirmation of approval will be made by the Integration Partnership Board at national level during November 2019;

(c)  the BCF Plan for 2020/21 will be produced to the current system, but this may then change in following years in the context of the new NHS Long Term Plan, with the potential introduction of a new three-year plan with modified metrics (as the current metrics are not specific to the BCF Plan). It is likely that work will be carried out more closely with the Integrated Care Partnership (ICP) for joint commissioning and funding, and the ICP will be briefed on current BCF spending, and on where funding has been directed in the past;

(d)  this represents an important opportunity for partners to discuss doing things differently in closer partnership, in the context of very challenging budgets. It is also an opportunity to consider what form the BCF needs to take going forward and what activities it needs to support, and how its governance systems can be developed to support this. Current BCF reporting will be reviewed to remove any programmes that were initially supported under the BCF, but are now provided for by other means.

RESOLVED to approve the 2019/20 Nottingham City Better Care Fund Plan, as set out in the report.

Reasons for the decision

To implement the Nottingham City Better Care Fund Plan 2019/20, which has the key objectives to remove false divides between physical, psychological and social needs; focus on the whole person, not the condition; support citizens to thrive, creating independence – not dependence; tailor services to need – hospital will be a place of choice, not a default; and not incur delays – people will be in the best place to meet their need. The vision is that, in five years’ time, care is integrated so that the citizen has no visibility of the organisations and different parts of the system delivering it.

Other options considered

To do nothing: This option is rejected because it is a national requirement for the Local Authority and Clinical Commissioning Group to agree a joint BCF fund and 2019/20 BCF Plan.