Agenda item

To consider a report from the Interim Executive Director for People, Adults.

Members considered a report which set out the Better Care Fund (BCF) Plan 2021/22 for approval by the Board as this was one of the national conditions within the Policy Framework.

 

Officers also provided members with a presentation to accompany the report which is attached as an annexure to these minutes.

 

Areas of discussion/questions

The Plan had been approved by senior DC and CCG officers.

 

In respect of maintaining independence, how well developed was this and could assistive technologies be used more widely?  This was another enabler for keeping people at home more. Colleagues were looking into the digital offer which was an area for further development. A change of contracting providers in this area was currently taking place. 

 

Although a number of areas within the report were familiar it could be useful to consider spending time on getting behind the scenes e.g. Home First.  There were opportunities to use the Place Based Partnerships to look into more of the detail in the headline areas. More of a strategic conversation to join up the dots was suggested.

 

In respect of Home First, Healthwatch Dorset were about to start gathering feedback from carers.  There would also be a report on Home First and Sufficiency at the People and Health Scrutiny Committee on 31 January 2022.

 

It would be helpful to know how many people were in the system, those being helped not to enter the acute system and those being helped to discharge. How and where did the performance information sit?  Identifying areas where the Board was in a position to assist would be useful.  A number of data sources were highlighted. The Corporate Director for Commissioning undertook to look to provide this information outside of the meeting. In respect of data this was currently sat at local authority level but the Deputy Director of Primary and Community Care, Dorset CCG undertook to speak to business and intelligence colleagues to see how much further this could be interrogated. The Interim Executive Director for People, Adults noted the importance of having the conversation about what was being put in place.  Funding needed to be in preparation for what needed to be impacted in Place.

 

The community support in the Plan was highlighted but it was felt more about voluntary support could be added.

 

The definition of what the BCF was using as a locality – was this part of the Place conversation?  Possibly an informal discussion for the Board would be helpful.  It would be useful to have the context of what was delivered through the BCF for instance in respect of older people.

 

There were currently some very ‘hot’ issues in the system as a result of workforce pressures etc.  Real significant pressures in the community care system were highlighted.

 

The system health inequalities group could support the work under the BCF in reducing health inequalities.

 

Reference was made to all three hospitals in the Dorset and BCP area and how they were currently running at 100%.

 

Conscious of great initiatives taking place although a key failure did seem to be around communication and refence was made to a recent experience of a failed discharge.

 

In respect of lessons to be learned for improvement, the importance of listening to people’s experiences was highlighted to ensure services worked better. The Interim Executive Director for Adults, People highlighted that this happened in her directorate on a case by case basis in a multi disciplinary way. It was considered if feedback could be gained through the PPGs.

 

Reference was made to interviewing patients at home for use as learning exercises for staff and a similar approach to discharges could be considered.

 

The importance of ensuring that the right schemes were in place for young people entering adulthood and the opportunity for Children’s Services to extend the conversation was highlighted.

 

Data sharing was key. The use of trusted networks and agencies was an opportunity to gain honest feedback. It was important to recognise the voice of the community.

 

It was felt there was still room for some improvement in the BCF.

 

‘Minded to’ Decisions

That the Health and Wellbeing Board supported the following recommendations:-

 

1.    That the Better Care Fund Plan for 2021/22 be approved.

2.    That the Board receives an update report on progress to date at the March and November 2022 meetings

3.    That delegated authority to approve subsequent plans if a Health and Wellbeing Board meeting cannot be convened within the NHS England sign off period, to the Executive Director for Adult Care and Housing following consultation with the Health and Wellbeing Board Chair be given.

 

The Interim Executive Director of People, Adults, having heard the debate, confirmed the ‘minded to’ Recommendations, under delegated powers on behalf of the informal meeting of the Health and Wellbeing Board.