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






Better Care Fund Plan - 2021/22 and 2022/23

Date of Meeting:


08 March 2022

Report of:


The Manging Director, Brighton & Hove CCG/The Executive Director, Health & Adult Social Care




Kaur Harpreet/Michelle Jenkins/Giles Rossington





Wards Affected:






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 (Part A) the approved BCF Plan for 2021/2022 and (Part B) the plan for 2022/2023.   The Plan for 2022/23 will require approval by the Health and Wellbeing Board and further approval for the extension of the BCF Section 75 agreement, which governs the joint fund between the council and the CCG, beyond its current end point of March 2022 to enable continuance of funded schemes to March 2023.



1.           Decisions, recommendations and any options


1.1         That the Board notes the BCF Schemes delivered in 2021/22 and NHSE Guidance received in the 2021/22 Approval Letter that:


“all BCF are required to  review and revise BCF discharge ambitions and activity plans in order to support the aim of maximising capacity across acute and community settings – enabling the maximum number of people to be discharged safely and quickly, home wherever possible, and supporting people in their own homes”


1.2          That the Board approves the proposal to prioritise stability into 2022/23 by carrying forward all schemes funded in the previous year, subject to minor amendments resulting from scheme review and any further guidance issued in year by NHS England.


1.3         That the Board authorise the Executive Director Health and Adult Social Care and the Manging Director, Brighton & Hove CCG to agree and execute an extension to the Better Care Fund Section 75 Partnership Agreement (the Agreement) between the Council and the Brighton & Hove CCG to extend the Agreement to March 2023



2.    Relevant information – Part A: BCF 2021/22 Plan


2.1           The BCF plan for 2021/22 is attached as Appendix 1.  The plan was submitted to NHSE in line with required timescales and an Approval Letter was received by the Chair of the Health and Well-Being Board and CEO of the CCG on 11th January 2022.  This enabled formal transfer of funds against the plan, including pooled funds under the 2021/22 Section 75 agreement. HWB agreed an extension of the in-year Section 75 agreement governing the use of pooled funds to March 2022.


2.2          The application of the BCF and the schemes within were a continuation from the previous year and covered funding for services of £33.5million.  Keeping the BCF stable 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. 


2.3          There was some above inflation growth in the fund in 2021/22.  Additional resources were 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.




3.    Relevant information – Part B: BCF 2022/23 Plan


3.1         The BCF plan for 2022/23 is attached as Appendix 2.  All schemes currently funded were subject to individual review in 2021 to ensure their compliance with national BCF expectations and local Health and Wellbeing targets.


3.2         Excepting some minor, in-scheme amendments, it is proposed to maintain our emphasis on stability and continue all currently-schemes for 2022/3. Proposed scheme amendments have been jointly-agreed with stakeholders and providers and will be achieved within current financial allocation. 


3.3         The 2022/23 BCF allocation is not yet confirmed but it is expected to include a 5.2% inflationary uplift. 


3.4         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 has already authorised extension of the S75 arrangements to March 2022 to align with the funding proposals for the BCF Plan 2021/22.  


3.5         It is further requested that the Board approves extension of the existing Section 75 Better Care Fund agreement. The existing Better Care Fund Section 75 Partnership Agreement between the Council and Brighton & Hove CCG currently covers the following programme areas:-


·         Increasing System Capacity

·         Integrated Discharge Planning

·         Protecting Social Care

·         Supporting Recovery and Independence

·         Person Centred Integrated Care

·         Dementia Planning


3.6         The Agreement sets out the pooled fund contributions from each area in respect of each of the programmes and a governance framework for the commissioning and delivery of the Better Care Fund and the management of budget and expenditure.


3.7         An extension is proposed to extend the Section 75 Agreement to 31 March 2023 to reflect the BCF 2022/23 funding.



4.    Important considerations and implications


4.1       Legal:

It is a requirement that the Better Care Fund is managed locally through 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 2022-23.


Lawyer consulted:        Elizabeth Culbert                     Date: 090222


4.2      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. Contributions are in line with nationally mandated requirements.


The CCG funding totals £21,507k, which is made up of contributions based on the Social Care formula (RNF) £6,940k and CCG Core Allocations £14,567k.  There is a separate minimum percentage uplift required for each element.  For Brighton and Hove in 21/22 this was 5.3% for the RNF element and 4.9% for Core funds.


The Council contribution of £12.011m comprises of £9.181m Improved Better Care government grant funding and £2.313m from the Disabled Facilities government grant, which conditions stipulate must be pooled within the Better Care Fund. The remaining £0.517m is an additional discretionary Council contribution towards various Better Care workstreams including the Community Equipment Service and Carers support.


From this funding there is a minimum level of expenditure required for both NHS Commissioned Out of Hospital services (£6,112k) and Adult Social Care Services (£8,632k).Any spend variance at outturn is subject to a risk share as per the section 75 agreement. The forecast variance for 2021/22 as at February 2022 is an £0.018m underspend.


The Better Care Fund budget allocations for 2022/23 are yet to be confirmed but based on the 5.2% inflationary increase referred to in paragraph 3.3 of this report, the budget will be approximately £35.261m. As part of budget setting the Council has assumed that the existing local authority schemes will continue in to 2022/23.


Finance Officer consulted:     Sophie Warburton        Date: 09/02/2022



None specifically



5.           National Guidance and Local Priorities


5.1         Since its inception in 2013 the Better Care Fund has promoted joint working between the NHS and Local Government, placing the wellbeing of people as the focus of health and social care services and shifting resource into social and community services. As such it aligns to our “wells” vision of health and wellbeing in our city, particularly the ambition of living well, ageing well and dying well for all Brighton and Hove citizens.


5.2         NHSE targets for local BFC schemes are derived from national performance metrics.  In 2021/22 these focused on five key areas:  avoidable hospital admissions, length of hospital stay, discharge to normal place of residence, admissions to residential care and effectiveness of reablement schemes.  


5.3         A line-by-line review of all BCF funded schemes in 2021/22 concluded that all schemes contribute in good measure to achievement of the metrics in Brighton and Hove, through further work will be conducted to bring closer alignment (where practicable) between individual scheme performance indicators and relevant BCF metrics.


5.4         In Quarter 4 of 2021/22, NHSE required all BCF schemes to review and revise BCF discharge ambitions and activity plans in order to support the aim of maximising capacity across acute and community settings – enabling the maximum number of people to be discharged safely and quickly, home wherever possible, and supporting people in their own homes.  This was in response to the Level 4 emergency declared across the NHS in light of the confluence of winter-pressures, workforce pressure and the surge in Covid infections caused by the Omicron variant.


5.5         We await NHSE full guidance on the application of the 2022/23 BCF fund and it is not yet known if there will be further adjustments to the priority areas and target metrics.  However, we are confident that all current BCF schemes are working to maximise capacity across the system and enabling timely and sustained support to people at home.



6.    Stakeholder Engagement and Consultation


6.1         BCF plans for each year are reviewed through local planning processes with all system partners to provide assurance that it supports the Brighton & Hove health and wellbeing strategy and has met / is compliant with the national planning criteria.


6.2         Additionally, each scheme funded by BCF has specific requirements for stakeholder engagement, consultation and responsiveness to service users, family and friends.  Long-term funded schemes are subject to periodic review or re-tendering processes, with the involvement of representative groups  - for example, the valuable input of Healthwatch to the 2021/22 evaluation of Community Equipment Services.



7.    Equalities


7.1         All BCF schemes supported locally are required to make a meaningful impact on tackling health inequalities in our City and the programme as a whole makes conscious choices to promote equality, including locating resources in traditionally-disadvantaged areas and enabling access to acceptable care by traditionally-excluded and marginalised communities.



Supporting documents and information


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

Appendix 2 – BCF Finance Tables