Agenda and minutes

Sara Storey – Director for Adult Health and Social Care, Nottingham City Council

Sarah Fleming - Head of Joint Commissioning, NHS Nottingham and Nottinghamshire Integrated Care Board

None.

Minutes of the meeting held on 30 November, for confirmation

An addition was requested by members of the Committee under Page 2 item 10, under ‘Comments from members of the Committee’, to capture a comment that the expenditure in the report is projected to stay the same over the duration of the proposed eight year contract year-on-year and that there is a need to take into account the current context of inflation increasing costs and reducing affordability.:

With the addition above, the Committee confirmed the minutes of the meeting held on the 30th November 2022 as a correct record and they were signed by the Chair:

Joint report of the Director of Commissioning and Procurement and the Programme Director for System Development, Nottingham and Nottinghamshire Integrated Care Board

This item is not subject to call-in as it is for retrospective approval.

Naomi Robinson, Joint Commissioning Manager, Nottingham and Nottinghamshire ICB, presented a report on behalf of Sarah Fleming, Programme Director for System Development, Nottingham and Nottinghamshire ICB, seeking retrospective approval for the Nottingham City 2022-23 Better Care Fund (BCF) Adult Social Care Discharge Fund planning requirements, which were submitted to NHS England on the 16th December 2022. The following information was highlighted:

(a)  the BCF Adult Social Care Discharge Fund was announced on the 16th November 2022. The fund is targeted at interventions that best enable the discharge of patients from hospital to the most appropriate location for their ongoing care. The aim of the fund is to free up the maximum number of hospital beds, reduce bed days lost and to boost general Adult Social Care workforce capacity through recruitment and retention where this reduces delayed discharges;

(b)  the funding was planned to be released in two tranches, with 40% released in December and the remaining 60% at the end of January 2023, subject to a satisfactory planned spending report and fortnightly activity data;

(c)  Nottingham City Council, Nottinghamshire County Council and Nottingham and Nottinghamshire ICB established a task and finish group to co-ordinate the submission for the Discharge Fund;

(d)  submission of the plans to NHS England was due on the 16th December 2022 and therefore plans were approved by delegated authority. The plans were approved by Mel Barrett, Chief Executive, Nottingham City Council, and Amanda Sullivan, Chief Executive, Nottingham and Nottinghamshire ICB. 

The following points were discussed during the discussion which followed:

(e)  a plan had to be created very quickly to use the funding to support hospital discharges. Numerous measures are outlined in the plan to support recruitment of social care staff, to retain, incentivise, and increase capacity among the existing workforce, to use agency workers, to increase brokerage support, and for other measures to support hospital discharges;

(f)  Local Authorities and the ICB worked well together to produce a well-considered plan within two weeks, as it was crucial to accept any money available to support the City. The team tried to strike a balance between supporting immediate measures to help deal with winter pressures on the health service, and to get ahead with some of the plans for the next year, such as the recruitment campaign;

(g)  due to the urgency, the plan could not come to the Committee in time for approval. It has been approved at senior levels in Nottingham City Council and the ICB;

(h)  since submitting these plans, Nottingham City Council have decided to levy the full Adult Social Care Council Tax precept, and the team are completing the reports with information requested by NHS England as a condition, so there should not be any issues in receiving the second tranche of funding; 

(i)  although teams did come up with some useful measures very quickly, short-notice funding is not an ideal way to forecast and plan for the future. The Health Service is facing a crisis, particularly around Adult Social Care. The underlying issue is around getting staff and providers to pick up contracts for home care, and the money is not available for a long-term plan to address this issue;

(j)  NHS England have indicated that funding will continue in further years, but this is not certain. They have indicated there should be a multi-year offer released in March;

(k)  it would be useful to see a cost-per-bed breakdown to see the value for money of this tranche of funding, while it was so short-term. It would be useful to show what measures worked most effectively to put forward in future proposals;

(l)  Section 75 agreements will need to be updated to take account of these plans.

Resolved to approve the 2022/23 Better Card Fund Adult Social Care Discharge Fund plan.
 

Reasons for the decision:

·  The report template was agreed for submission to NHS England by the Chief Executives of Nottingham City Council and Nottingham and Nottinghamshire Integrated Care Board, subject to formal ratification at the Nottingham City Health and Wellbeing Board Commissioning Sub-Committee on the 25th January 2023.

·  The Nottingham City Health and Wellbeing Board Commissioning Sub-Committee is asked to formally ratify the submission template. The Nottingham City 2022-23 Better Care Fund Adult Social Care Fund template submission is shown in full at Appendix 1 of the report.

Other options considered: No other options considered.

29 March 2023

29 March 2023