Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to the Clinical Commissioning Group (CCG), the Local Safeguarding Board for Children and Adults and Healthwatch.

Title:	Better Care Fund Plan - 2021/22
Date of Meeting:	17 December 2021
Report of:	The Manging Director, Brighton & Hove CCG/The Executive Director, Health & Adult Social Care
Contact:	Kaur Harpreet/Michelle Jenkins/Giles Rossington
Email:	giles.rossington @brighton-hove.gov.uk
Wards Affected:	All
FOR GENERAL RELEASE
Executive Summary The Better Care Fund (BCF) is an important element of delivering the Brighton & Hove placed based plans and supporting the delivery of the Health and Wellbeing Strategy.  The joint fund held by the Council and the CCG supports schemes which deliver on our local priorities that support admission avoidance, enhanced personalisation, supporting hospital discharge, reduced Length of stay, equality and health inequalities.  This report presents the BCF Plan for 2021/2022 for approval and seeks approval to extend the BCF Section 75 Agreement which governs the joint fund between the Council and the CCG to March 2022.

1. Decisions, recommendations and any options

1.1 That the Board approve the BCF Plan, submitted to NHSE on 16 November 2021/22. 

1.2 That the Board authorise the Executive Director Health and Adult Social Care and the Manging Director, Brighton & Hove CCG to finalise and enter into an extension to the Section 75 Partnership Agreement for the commissioning of health and social care services from the Brighton & Hove Better Care Fund to cover the period to March 2022, reflecting the 2021/22 funding allocations.

2. Relevant information

2.1       The BCF plan for 2021/22 requires approval by the Health and Wellbeing Board in response to national guidance that was published in October 2021.  Priorities in responding to the Covid-19 pandemic resulted in the late publication of national planning guidance on 29^th September with the final submission date of 16^th November and there has been limited opportunity to present the BCF Plan to the Health and Wellbeing Board within this period.  The BCF Plan Submission for 2021/22 is attached as Appendix 1 for approval.  The plan has been submitted to NHSE in line with required timescales but is subject to HWB approval before national moderation and NHSE sign-off of the plan.

2.2       The Health and Wellbeing Board are asked to consider and approve the Better Care Fund Plan for 2021/22 prior to it being moderated by the NHSE/I assurers in December.

2.3       The application of the BCF and the schemes within it are a continuation from the previous year and covers funding for services of £33.5million.  For 2021/22, given the focus on responding to the pandemic and the direct and indirect impacts of that, the restoration and recovery of services, all schemes funded for the previous year are retained to ensure continuity and stability for service users and providers through the pandemic. Keeping the BCF this year as a continuation of last year and within the framework previously agreed by the HWB was a conscious and deliberate approach to give certainty and security to schemes through the pandemic by supporting people at a time when all system partners and providers were focussed on the Covid response. 

2.4       There has been some above inflation growth in the fund this year.  Additional resources have been used to meet increases in demand and activity in individual schemes and measures to improve system capacity and capability to support health and social care pressures and patient flow.

2.5       The BCF plan has been through local planning processes with all system partners to review and provide assurance that it supports the Brighton & Hove health and wellbeing strategy and has met / is compliant with the national planning criteria.

2.6       The Better Care Fund plan and approach for 2022/23 will be considered for the March meeting of the HWB. 

2.7       The BCF Section 75 Agreement provides a governance framework for the commissioning and delivery of the Better Care Fund and the management of budget and expenditure. It describes how any potential overspend or underspend will be identified and any action required to bring expenditure back into line with budget. The Board is requested to authorise the extension of the S75 arrangements to March 2022 to align with the funding proposals and the plan to consider the plan and approach for 2022/2023 at the HWB in March 2022.

3.      Important considerations and implications

            Legal:

It is a requirement that the Better Care Fund is managed locally though a pooled budget. The power to pool budgets between the Council and the CCG is set out in the NHS Act 2006 and requires a formal Section 75 Agreement. Regulations prescribe the format and minimum requirements for a Section 75 Agreement and a template Better Care Fund Section 75 Agreement has been made available by the Department of Health and will be used for this purpose. An extension to the Section 75 Agreement is required to reflect the new funding arrangements and priorities as set out in the Better Care Fund Plan 2020-21.

Lawyer consulted:        Elizabeth Culbert                     Date: 091221

            Finance:

The Better Care Fund is a section 75 pooled budget which totals £33.518m for

2021/22. The CCG contribution to the pooled budget is £21.507m and the Council contribution is £12.011m, which includes the £9.181m Improved Better Care fund. Any spend variance at outturn is subject to a risk share as per the section 75 agreement.

Finance Officer consulted:     Sophie Warburton        Date: 09/12/2021

Equalities:

None specifically

Supporting documents and information

Appendix 1 -  BCF Narrative Plan 2021/22 [Word Doc]

Appendix 2 – BCF Planning 2021/22 [Excel File]