Alan Lotinga: LGA Financial Adviser and BCF Consultant Contact details: alan.lotinga@ntlworld.com 07914014252 or 01785 663039. Date www.local.gov.uk Insert date www.local.gov.uk

TCP FINANCIAL KLOEs/GUIDELINES Have the partners in the TCP clearly spelt out the mechanisms for how funding will be shifted from NHSE Specialised Commissioning to CCGs, using CCG allocation shifts, when Specialised Commissioning beds are closed? Does the TCP have a clear understanding/agreement in principle for the vehicles to be used to shift funding from each CCG to the relevant local authorities, including for dowries, S75, S256, Better Care Fund, etc.? (the plan must be specific about which mechanism the TCP intends to use and when it will be in place) Have the partners in the TCP articulated a clear set of shared principles governing how they will work together to ensure funding flows across the system to enable transformation?

TCPs – FINANCIAL PRINCIPLES From “Building the Right Support” and its FAQs, the primary principles are that funding follows the person and that movement of funds and risk-sharing to be managed across the TCP footprint (48 of them) Local TCPs will be asked to use the total sum of money they spend as a whole system on people with a learning disability and/or autism to deliver care in a different way that achieves better results, and that   The arrangements for pooled budgets will need to be agreed and negotiated locally to ensure that no partner is disadvantaged by the arrangements and that the risks are shared across the partnership. If there is a single pot of money that is currently being spent on health and social care, including inpatient care, then it doesn’t matter if that money is spent on social care, CHC or section 117 aftercare if the money can follow the person and shift around the system. However, there are of course some practical problems that need to be addressed….

TCPs AND FINANCE – SOME PRACTICAL ISSUES AND HELP GIVEN/IN HAND Some challenges and concerns: Cost-shunting and trust; financial planning and modelling; release of NHS Spec Com monies; cross-boundary issues; a reminder of statutory duties (eg outcomes of assessments, Care Act, CHC, S117); funding of transition costs/dual-running; a range of “maturity” of resource pooling experience; hosting of and other pooled budget arrangements. Help: National, regional and local TCP workshops, joint with NHSE, some specific to finance, and supported by model assurance questionnaires; Funding Transfer Agreements (FTAs) between Spec Com and CCGs; supporting NHSE with national templates and assurance of plans; MOU guidance; “dowry”S75 and S256 model agreements; intelligence from and to a range of events, Board meetings, Clinical Scrutiny Panels; new LGA Senior Adviser and NHSE Housing posts.

TCP (ADASS) REGIONAL QUESTIONNAIRE Range of similar issues and risks, but with variations, being raised across the 48 TCPs General cost pressure concerns via e.g. ADASS 2017 Budget Survey Particular concerns around financial issues and risks, but also linked issues – governance and LA engagement; join-up on modelling, planning and commissioning; quality and safety concerns Started from TCP financial KLOEs. Longer version of questionnaire (using that in West Mids), shortened to version sent out to all ADASS regions Discussion workshops aiming to: share and promote good practice; see what else can be done locally, regionally and nationally that isn’t already being done; help focus new support and efforts e.g. Senior Advisers.