Better Care Fund John Webster – Director of Commissioning Chris Badger – Assistant Director – Health and Social Care Integration

Recap - What is the Better Care Fund? “The Better Care Fund is a single pooled budget to support health and social care services to work more closely together in local areas.” “It provided an opportunity to transform local services so that people are provided with better integrated care and support.” “The Fund will support the aim of providing people with the right care, in the right place, at the right time, including through a significant expansion of care in community settings.” NHS Planning Guidance, December 2013

Make up of fund nationally 2015/2016 (billions) N.B. this is minimum that can be pooled

The Proposed Pool Commissioning AreaENCCG (£’000) ENCCG COMMISSIONING AREAS AND SPEND Existing CCG allocations to social care9, 063 Hertfordshire Community Trust services for older people21,420 Other intermediate care2,198 Continuing Care13,506 Carers272 Other4,938 Total51,397 HERTFORDSHIRE COUNTY COUNCIL COMMISSIONING AREAS AND SPEND Assessment and Care Management 5, 334 Residential and Nursing 36, 508 Community Services 15, 847 Direct Payments 1, 968 Flexicare Housing 2, 993 Other Older peoples 874 DFG Allocation ,588 Social care capital 1,151 Total66,262 TOTAL BETTER CARE FUND FOR EAST AND NORTH HERTFORDSHIRE117,659

Enhanced ENHCCG role commissioning key social care services Residential budget £36.5m -Focus on quality, Carehome premium and link to Enhanced Primary Care Support to patients in care homes -Enablement bed provision Homecare provision – £15.8m including full review of homecare contracts in 2014/14 -Discharge to Assess and ‘Home from Hospital’ homecare -Enablement care -Rapid response homecare to support HomeFirst -Dementia and End of Life ALL OF THE ABOVE CENTRAL TO HELPING PEOPLE BE INDEPENDENT AND MANAGING ACUTE PRESSURES

Joint commissioning to deliver outcomes Better Care Fund Joint Commissioning National and local metrics National conditions Integrated Working Better Care Plan- Health and Well- Being Board JOINT COMMISSIONING STRUCTURES WITH KEY ROLE FOR PROGRAMME BOARDS

Joint engagement events to seek views on BCF priorities for integration (214 attendees, 86 organisations) Joined-up, coordinated care between statutory services, voluntary and community groups, and individuals, their families and carers Communication of and between services helping to support individuals in their choice of care Prevention and self-management to preserve good health and wellbeing Rapid access to community services

Emerging vision for integration 1.Services work together to maximise the independence of people in Hertfordshire 2.Effective integrated community services built around primary care 3.Jointly commission services around individuals and their needs 4.An integrated workforce, appropriately skilled and able to work across organisational boundaries

Objectives Improved life expectancy at 75 with narrowing variation across the County Reduce admissions of 65 and overs to acute care and maintain people’s independence for as long as possible People are re-abled and rehabilitated as effectively and quickly as possible after a crisis or exacerbation People die in their place of choice

Objectives continued There is quality care for people with dementia Stroke patients receive timely and quality acute care, and their rehabilitation potential is maximised

National metrics Admissions to residential and care homes Patient / service user experience Avoidable emergency admissions Delayed transfers of care Effectiveness of reablement

Next Steps Develop joint governance and joint commissioning structures for Better Care Fund Develop joint programme to deliver integration Early work to get momentum -Stroke pathway -HomeFirst -Intermediate care