Decision details

To approve the Section 75 Arrangements effective from April 2023.

RESOLVED that

i.       Approval is given to the Executive Director: People, on behalf of BFC, to agrees and enter into a S75 agreement from 1 April 2023 effective for a period of 3 years, with added service schedule information for 1 April 2023 – 31 March 2024

ii.     the recommended model of future S75 agreements is agreed as illustrated in

section 3.11 and 3.12 and appendix A and note proposed improvements in

development with Frimley ICB to the current S75 Agreement.

iii.    Authority be delegated to the Executive Director: People and the

Executive Member for Adult Services, Health and Housing to approve and sign off the core S75 Agreement and Schedules. Spend for these schedules will be determined by the Better Care Fund policy framework / budget and Adult Social Care budget.

iv.    The Better Care Fund Budget for 22/23 is noted, as £18,136,342 with the BFC contribution £10,132,342. In addition, the Adult Social Care Discharge Fund is reported through the Better Care Fund with a total value of £433,416.

i.       The current S75 Agreement expires 31 March 2023. Existing and new  services that are jointly commissioned and/or funded through a pooled budget need to be covered through a S75 Agreement in order to be compliant with the NHS Act 2006 and have a clear working protocol between  Frimley ICB and Bracknell Forest Council.

ii.     The current S75 Agreement requires a refresh in the context of the devolution of all CCG’s  and  the  formation  of  Integrated  Care  Boards.  Further  opportunity  exists  to review our joint working approach in the context of inflation, joint uplift processes and renewal timeframes.

iii.     In addition, the Better Care  Fund  Schedule  and  Heathlands  Schedule  will 

require updating to reflect current practice / service delivery

iv.    The Better Care Fund (BCF) is one of the government’s national vehicles for driving health and social care integration. It requires integrated care boards (ICBs) and local government to agree a joint plan, owned by the Health and Wellbeing Board (HWB). The joint plans utilise pooled budgets to support integration and is governed by an agreement under section 75 of the NHS

Act (2006).

v.     The Better Care Fund policy framework is published each year and outlines national conditions and metrics. Local Health and Wellbeing Boards are able to set their own priorities driven by local need. Stringent joint planning and review activity is undertaken throughout the year to ensure an integrated approach to providing joined up care.

vi.    Once  developed,  the  Better  Care  Fund  plan  is  signed  off  by  both  the 

Executive Director: People and the ICB Place Convenor for Bracknell before being presented to the HWB for sign off by the HWB Chair.

vii.   Monthly  integrated   Delivery   Group   and   Strategic   Group   meetings   take place throughout  the  year  to  inform  and  develop  the  BCF  in  order  to  support  the  above planning process.

viii.  In order to assist in prioritisation and assurance of the 2023-2025 planning cycle a full review of the current BCF plan has recently been undertaken. Please see Appendix B for the review details. Each scheme is highlighted in detail along with an outline of the metrics and locally agreed priorities.

ix.    It is prudent to undertake the above planning activities in anticipation of the

publication of the policy frameworks as publication occurs most often partway through the financial period we are required  to  plan  for.  For this reason,  The  Executive  is  asked  to retrospectively  note  the  budget  for  the  BCF  2022/2023..  The Executive approved the S75 extension paper in March 2022 (Appendix   C) At this stage, the 2022/2023 policy framework and ICB minimum contributions had yet to be published. In addition, the Adult Social Care Discharge Fund, published in Autumn 2022 is to be  included  in  the  BCF 2022/2023  budget  retrospectively.  Please see Appendix D for the current S75 2021/2022 which was extended March 2022 as above.

x.     In the quest for best practice, Bracknell Forest Council, Frimley ICB and Berkshire Healthcare Foundation Trust agree that a wider scope of current joint services across Adult Social Care should also be reflected as schedules within the S75 Agreement

xi.    Ongoing discussions with our ICB colleagues in leadership and governance have been positive and yielded an agreed approach to:

3.11.1 A streamlined efficient model

3.11.2  A refresh of our joint approach to inflation, uplifts and risk sharing forming the ‘core’ element of the S75 Agreement – valid for a period of 3 years subject to legislation change

3.11.3  The  joint  development  of  a  suite  of  Schedules  which  report  jointly  agreed governance, reporting arrangements, spend, impact and outcomes. These schedules will need to be  reviewed on an annual basis to reflect current service provision and / or budgetary adjustments.

With reference to 3.11.2 The Executive is asked to note that the Executive Director : Resources  will  be  consulted  in  relation  to  inflation  and  risk  share  arrangements. Together  the  Executive  Director:  People  and  Executive  Director:  Resources  will provide effective governance across the broad remit of the S75 and BCF Plan 2023- 2025.

xii.   Streamlined approach may lead as an example across the other geographical areas of the Frimley Integrated Care System.

i.       Other options such as extending the existing S75 Agreement or not renewing the S75 Agreement are not feasible options as would lead us to be non-compliant.

ii.     An alternative approach to developing a separate S75 agreement for each individual joint service has been considered but there is joint agreement that this approach is not efficient, time and resource heavy and would lead to repetition across the various S75’s.

None