Agenda item

Integration Transformation Fund

The purpose of this report is to explain the background, details and conditions of the Integration Transformation Fund and to propose an approach and timescale for developing the Integration Plan.


It was noted that the Government had now named this fund the ‘Better Care Fund’. Guidance on this fund would be published in the following week. Eve Baker would be the lead on this work from the CCG Federation.


The Director of Adult Social Care, Health & Housing (ASCH&H) made the following points:


  • The Better Care Fund advocated that the person receiving care should be placed at the centre of their care and that all services and support should be organised in such a way so as to maximise outcomes. The Fund also aimed to reduce reliance on A&E and urgent care.
  • The timescales were challenging and a high level plan would need to be in place by February 2014. This plan would need to set out vision; detailed information could be added at a later stage. The Plan would need to prioritise people and to ensure that services were in the right places, this would mean work taking place outside the borough. This was inevitable given that all hospitals used by Bracknell Forest residents were outside the borough.
  • The Joint Health & Wellbeing Strategy was designed to ensure seamless healthcare, the strategy would be the basis of developing the plan and there would need to be an emphasis on having an ambitious vision but continuing to deliver local outcomes for the local population.
  • The Board would play a key role in supporting the role of local leaders and would benefit from the strong foundations already established locally.
  • A pragmatic approach would be necessary to build on joint working where it was working well and to work independently where this secured better outcomes for people. It would be necessary to measure and evaluate work along the way.
  • The Better Care Fund advocated developing joint plans and an increased emphasis on seven day working. This would necessitate data sharing and integrating systems and a joint approach to assessment and care planning. Organisations would need to share risks and have contingency arrangements across organisations.  


In response to members’ queries, it was reported that differences would be seen by local people in the way services were delivered by integrated care teams. This work was already taking place locally for people with long term conditions. This care involved wrapping a team of people around the recipient; however one person would be responsible overall all for the recipients care. One care plan would be developed, creating a holistic and integrated approach to care. There were still issues that needed to be resolved such as agreeing consent across organisations, however this work had now been running for six months and a reduction in hospital admissions had been seen as a result.


The Director of ASCH&H reported that patient views would be sought on integrated care and the Board would also be consulted. It was reported that in terms of patient and public involvement in the development of plans, a reference group had already been established which Healthwatch already sat on and there were a number of other consultations and opportunities for the public and patients to contribute to. The Board were clear that all organisations would be keen to see strong public engagement.


The Chairman stated that it was critical that the impact on people of all plans was made clear at every stage and that plans were clearly communicated to the public. It was reported that the NHS Call to Action placed a duty on all health organisations to consult. In addition, Self Care Week was also used to ask people a range of questions about local healthcare services.


In response to members’ queries, it was reported that providers would need to be involved in the planning of services. With reference to paragraph 6.4.2 of the report around decommissioning it was noted that this presented a significant risk to providers, however this would change the pace of commissioning and allow specialist support to be commissioned. Providers would be supported to downsize where necessary.


The Director of ASCH&H reported that the Board would have a key role to play in ensuring organisations and services were kept on track and where things were going wrong to intervene to remedy this. The Board would hold a torch to the performance of all local services, plans, outcomes and activities.


Eve Baker, CCG reported that there was already lots of innovative practice taking place across the country and this would be considered when developing plans.  


It was noted that the methodology for allocation of funding had not yet been confirmed and it was hoped to be confirmed before Christmas and was likely to include deprivation.


The Director of ASCH&H confirmed that the Integration Task Force had been established and work was underway to develop integration plans where appropriate.


Board members noted that it was important to be clear that this work involved moving resources around and didn’t include new funding for services.


It was RESOLVED that the Board;


i)                    noted the requirements of the Integration Transformation Fund


ii)                   agreed the timescale and supported the approach to developing the Integration Plan for sign off by the Council’s Executive, Bracknell and Ascot Clinical Commissioning Group’s Governing Body and the Health and Wellbeing Board.  

Supporting documents: