The Board is asked to consider the report on the above.
Phil Hornsby, Director – Commissioning for People presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book which provided an update on the Better Care Fund and Home First Programme.
The Board was advised that the report considered budget issues, for extending existing BCF Section 75 agreements to include the impact of COVID 19 pooled expenditure. Members were informed that the Dorset Integrated Care System had been providing an enhanced supply of out of hospital care and support services, commissioned via BCP and Dorset Council on behalf of the system.
The Director reported that this service was to be extended to the end of March 2022 and the enhanced supply of out of hospital care and support services can be approved by delegated authority as outlined in the recommendations. (The Board was referred to agenda item 9 – Hospital Discharge Programme Funding).
The Board was updated on progress and performance of the Better Care Fund (BCF) Plan and Home First Programme for 2020/21 including information against each scheme. A national programme of work has taken place led by NHS England considering changes to the BCF from 2021 onwards. This report takes account of the new requirements, and the content of the report was in line with the BCF changed requirements recently provided (August 2021) and officers would continue to monitor changes and adhere to these as we progress.
Officers commented on the impact and demands of Covid as detailed in the report. The Board was updated on the operational aspects including additional capacity to support carers with a refresh of the Pan Dorset Carers Provision, in respect of maintaining strong and sustainable care markets key elements of work included the remodelling of Coastal Lodge for an enhanced intermediate care bedded unit for the ICS and a summary of the financial implications.
The Board was updated on the progress of Home First Programme, which was established in response to the national mandate to implement a full ‘discharge to assess’ model in each local system and supported by national hospital discharge funding. Officers outlined the programme focus which was on embedding the changes made to date and to establish a sustainable long-term model for intermediate care that would meet the evolving needs of the Dorset Population. Officers reported on the appointment of IMPOWER as the strategic partner who have commenced the diagnostic phase. The Board was advised of the Plan for the next quarter, which was to progress priority interventions, to address immediate challenges of increased demand, reduce flow and resilience in existing services.
The Board was informed that this was a significant programme of change and workforce pressures exacerbate the situation. The Director of Public Health reported that demand was unprecedented and therefore the focus should be on discharge from hospital, the community role and the integration of locality teams. The Board was informed that a more integrated approach was the goal and focus for the strategic partner IMPOWER. It was acknowledged that there was a role for the voluntary sector which could benefit from short term interventions. Members reported that it was key to not lose sight of the work undertaken pre-covid.
Debbie Fleming welcomed the Board’s focus on this topic. She explained the impact on those that remained in hospital including the risk of falls and infections. She reported that the key principle should be admission avoidance with the emphasis on the development of services outside of the hospital environment. The Board was informed of the need to avoid elderly emergencies and empower residents to look after themselves. Debbie Fleming highlighted the commitment to 7-day services with a robust response to social care emergencies. She reported that she was looking forward to working with partners. The Chairman echoed the points made and the potential implications for patients if they remain in hospital such as muscle wastage. Louise Bate commented on the potential role of Healthwatch in capturing the experiences of individuals. Councillor Rampton referred to the provision of appropriate services and mentors for health and social care training programmes. Debbie Fleming reported on the expansion of mentors and that staff have a good training experience. She explained that she would provide figures on this issue. Councillor Kelly emphasised the opportunities to work on strength-based communities to raise well-being.
(a) The performance against the 2021/22 BCF plan be noted.
(b) The revised BCF Guidance for 2022/23 – has additional focus on the Hospital Discharge Arrangement be noted.
(c) The progress made on the Home First Programme supported by Impower be noted.
(d) Authority for the sign off of the 2021/22 BCF Plan be delegated to the Chairman and Vice-Chairman in consultation with the Portfolio Holder for Adults and the relevant Officers to meet the 16 November deadline.