Agenda item

The Board considered a report providing an update on the Better Care Fund Plan (BCF) 2017/19 which was submitted to NHS England on 11^th September 2017 for approval. The report set out how the plan has been assured by the Regional Better Care Fund Manager, and how the Better Care Fund provides financial support for the closer integration of health and social care. The Board noted that the BCF Financial Plan was set out in Appendix 1 (funding sources, expenditure, BCF metrics and national conditions); the Swindon BCF Narrative Plan 2017/19 was set out in Appendix 2; the Delayed Transfers Of Care (DTOC) Plan (including the High Impact Change Self-Assessment) was set out in Appendix 3, and; the Adults with Needs Emerging Market Position Statement 2017-2022 was set out within Appendix 4.

Mrs Sue Wald, Director of Adult Services, Swindon Borough Council, introduced the report and confirmed that the initial submission from Swindon had not been accepted due to queries over the discharge figures. The Board noted that these figures had been revised, and the second submission approved.

Mrs Wald referred to a joint letter sent to Swindon Borough Council from the Secretaries of State for Health and Communities and Local Government on Swindon’s social care performance in relation to DTOC. The Board noted that the 2016/17 figures for delayed discharges in Swindon had been higher than the national average, but that concerns have been raised for the current year leading to the joint letter mentioned above. A further assessment on DTOC performance in Swindon will be undertaken using the data from September 2017, and a Care Quality Commission inspection may be triggered as a result.

Mrs Wald gave a presentation on the latest figures for DTOC (a hand out for which was circulated at the meeting) which will also be considered by the A&E Board and the relevant Overview and Scrutiny Committee. Mrs Wald highlighted that the South West is the worst region nationally for ‘bed blocking’ and has had challenges in the domiciliary care market in the area. The Board noted that the DTOC figures for Swindon have dropped considerably since its peak in July 2017, and noted what the next steps will be to further improve the situation.

Following the presentation, and consideration of the BCF submission as set out in Appendix 1 – 4 of the report, Board members discussed the matters raised, including:

·       The removal of the social workers from the hospital wards prior to August, which had increased the number of days it took to move people in to residential care. The service has now been reinstated on the wards and workers are helping to ensure that people are better assessed and not just passed straight through to nursing care.

·       The reduction in the DTOC figures in Swindon since these issues were first considered by the Secretaries of State, and the hope that this reduction will be taken into consideration when assessing the September 2017 data.

·       The pressures faced by staff at the Great Western Hospital (GWH) when dealing with delayed transfers, and the importance of partners working together effectively during the winter period.

·       How GWH aims to release elderly patients early enough so they can arrive home at lunch time, and the challenges faced by patients should this not be the case. It was noted that Healthwatch Swindon can monitor this.

Resolved – (1) That the Better Care Fund Submission for 2017/19, attached at Appendix 1 – 4 to the report, be noted. 

          (2) That the update on the latest position with regards to Delayed Transfer of Care be noted.