Agenda item

Better Care Fund - Report for Q4 2018/19 and Update on planning for 19/20

To consider a report by the Executive Director for People - Adults, Dorset Council.


The Board considered a report by the Executive Director for People - Adults, Dorset Council, which set out the performance of the previous Dorset Health and Wellbeing Board area against the 2018/19 Better Care Fund (BCF) Plan and provided an update on planning for 2019/20 although final detailed national policy requirements had not yet been published.


Significant progress had been made last year in a number of areas - development of a joint brokerage function, alignment of budgets, joint quality approaches, successful implementation of two joint frameworks with a spend of approximately £650m over five years and joint provider market management.  Plans for an integrated approach to place shaping had also been progressed but further integration of commissioning functions and the pooling of budgets had provided more of a challenge.  For 2019/20 there were opportunities to take forward integration through the refresh of the Integrated Care System and the Sustainability and Transformation Plan (STP).  In summary, although improvements had been made in all areas targets had not been met and work needed to continue to improve performance.


With regard to whether performance was going in the right direction, it was explained that performance fluctuated over the year and final end of year figures are not yet available..  Once they are it  would be possible to compare Dorset's performance to that of other areas and see whether Dorset mirrored national trends.


As the timetable for completion of the BCF plan 2019/20 does not fit with Board meetings, a delegation was sought to sign off the BCF plan outside of Board meetings.  The Chairman added that, because of the funding involved, she had previously consulted the appropriate Cabinet member as part of the signing off process and intended to do the same this year.


The Chief Operating Officer of the Dorset Clinical Commissioning Group welcomed improved performance with regard to delayed transfers of care.  The investment in primary care had improved patient flow, but peaks created pressure in the system and every part of the health and care system had a part to play in trying to prevent pressure building.


Members noted that work was continuing to prevent people being admitted to hospital in the first place, one of the key aspects being housing and the need for more suitable housing to be provided in order to prevent hospital admissions.  Partners had a role to play in this.


There was a brief discussion about the need to be able to measure levels of activity and ongoing work in primary care was noted.  The refresh of the STP also provided an opportunity to develop outcome measures beyond the BCF metrics.



1.   That authority is delegated by the Health and Wellbeing Board to the Chair of the Board and the Executive Director for People - Adults to agree Dorset's 19/20 Better Care Fund plan update.  This is in order to ensure plans can be submitted in line with the national timetable if the deadlines, once published, do not align with scheduled Health and Wellbeing Board meetings.

2.   Members of the Health and Wellbeing Board will be briefed in between scheduled Board meetings if the delegation needs to be used.

3.   The work to update the 19/20 plan should include refreshing the associated risks in the new Dorset Council's corporate risk register.

Supporting documents: