1. Better Care Fund Feedback from Westminster Briefing event 10 th June 2014

2. Centre for Public Scrutiny Speakers Ian Bainbridge: Deputy Director, People Communities and Local Government DOH Olwen Dutton: Bevan Brittan LLP Georgina Craig: Chair, NHS Alliance People Powered Health Network Professor Tom Downes: Clinical Lead for Quality Improvement. Sheffield Teaching Hospitals NHS Foundation Trust.

3. Centre for Public Scrutiny Overview Ian:BCF – what, why and a little on where we are now. Olwen:The Care Act and BCF Georgina: Community led commissioning Tom:Discharge to Assess – an integrated approach

4. Centre for Public Scrutiny Better Care Fund: We all know why – last six months of life, affordability, demography, demand 14 pathfinders: http://www.icase.org.uk/pg/dashboardhttp://www.icase.org.uk/pg/dashboard Negative press: ‘ Health and care integration could prove too costly for the NHS’ ‘Better care Fund plans are weak but integration is key to Quality’ NHS ‘concerns’ High expectations

5. Centre for Public Scrutiny By 2018 Integration the norm. Doing nothing is not an alternative Finland – the inefficiencies in our system Huge variation across the country around key areas such as transfer and re-ablement – not the acceptable face of localism. Challenge to the role of the HWB Board Sign off integration plans Engaging providers Concerns re more demand and more obligations – financially unsustainable Concerns re eligibility criteria – ‘trying to get the words right to ensure nil cost impact but local variability will mean there may be winners and losers, hope flexibility will resolve this’ Concerns re the new responsibilities around carers: Levels of demand unknown

6. Centre for Public Scrutiny Need for whole system thinking Everyone needs to make the shift - from hospital to community and prevention. Public Health centre stage: Skills around understanding the evidence base and how to gather evidence of success. Prevention – move from intervention at crisis stage to earlier intervention and advice for living well, empowerment and healthy communities

7. Centre for Public Scrutiny Challenges: Organisational survival Divided governance Perverse incentives Complexity Concerns: Noted but going ahead Looking at plans and their feasibility – some will receive more support (September)

8. Centre for Public Scrutiny Getting commissioning right - ‘experience led commissioning,’ involve the front line workforce. Involving Providers Role for Overview and Scrutiny? New ways of working – Social Impact Bonds, mutual, seeding co-production Design for outcomes Design in good outcomes for staff wellbeing – if the workforce is not supported then the patient experience will be poor. Involve everyone – Sheffield ‘discharge to assess’ Calculate the value Structural integration is not important – collaboration is