Decision Maker: Executive
Decision status: Recommendations Approved
Is Key decision?: Yes
Is subject to call in?: Yes
To approve the Section 75 Arrangements effective from April 2023.
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
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.
Reason Key: Affects more than 1 ward;
Wards Affected: (All Wards);
Financial Impact: To be incorporated into the report
Subject to Urgent Proceedings: No
Making Representations: In writing to the Executive Director: People.
Other reasons / organisations consulted
Internal, Frimley ICB, BHFT
Legal, Commissioning, Information Governance,
Frimley ICB, BHFT
Contact: Grainne Siggins, Executive Director People Email: firstname.lastname@example.org, Thom Wilson, Assistant Director: Commissioning Email: email@example.com Tel: 01344 354142.
Report author: Grainne Siggins
Publication date: 21/03/2023
Date of decision: 21/03/2023
Decided at meeting: 21/03/2023 - Executive
Effective from: 29/03/2023