Issue - items at meetings - Integration Transformation Fund (ITF) – 2014/15 and beyond

Report of Executive Director of Finance & Resources, Executive Director of Finance & Resources and Chief Finance Officer, Brighton and Hove CCG (copy attached).

(1)       That the actions needed to establish the ITF and the issues that it raises be noted.

23.1    The Committee considered a report of the Executive Director of Adult Services, Executive Director of Finance & Resources and the Chief Finance Officer, Brighton & Hove CCG which explained that as part of the June 2013 spending round the government set out the plans to establish a health and social care Integration Transformation Fund (ITF).  The report contained a table with indicative figures built from the national planning assumptions which quantified the likely value of this fund in Brighton and Hove.

23.2    The Chief Finance Officer, CCG presented the report and informed members that the proposed fund had two components as set out in paragraphs 3.2 and 3.3 of the report.  There were funds already in the system that would be pooled and their deployment would be overseen by the Health & Wellbeing Board, in line with a plan jointly agreed with the CCGs and the City Council.  The second component was to add to the existing pooled funds and release a further £10m from NHS funds increasing the fund to £18m.  This could only be achieved by joint working between Brighton and Hove CCG, BHCC and Brighton and Sussex University Hospital Trust. 

23.3    Additional funds could only be released if the investment planned for the integration of 7 day working in health and social care to deliver earlier interventions and reduce inappropriate admissions to hospital and the hospital reduce their capacity.  A key requirement was to have risk-sharing principals and contingency plans in place along side the investment plans for 2014/15 and 2015/16.  These plans were required to be developed and ready for implementation by the 31 March 2014.

23.4    Councillor Meadows noted that the Health & Wellbeing Board was being asked to agree plans and questioned why the Adult Care & Health Committee were not to be consulted first when there would be an impact on funding.  She asked if staff had been consulted about seven day working.

23.5    The Chief Finance Officer explained that plans had not yet been developed but were required by 31 March 2014.  The current report was for noting and was alerting the Committee of the fund and the impact on the Health & Wellbeing Board role.  This had happened as a result of national guidance and was not a local decision.  Joint plans would have to be presented to the Health & Wellbeing Board as the route for funding.  Moving to Seven day working would raise a number of practical issues and if working conditions changed there would be a formal process for the staff affected.   

23.6    Councillor Mears noted the plans for joint working and asked what would happen with regard to IT & communication systems.  Councillor Mears referred to paragraph 5.8 which stated that there were significant implications which would need to be reflected in budget strategies and the Medium Term Financial Strategy.  She stressed that it was important that the Committee had an oversight and impact on the budget papers. 

23.7    The Chief Finance Officer agreed that there needed to be a vast improvement in IT systems.  The CCG were working closely with the council with regard to financial planning.   

23.8    Councillor Meadows asked if the Adult Care & Health Committee could agree the plans before they were passed to the Health and Wellbeing Board for sign off.   The Executive Director stated that it was possible for the Committee to consider plans before being presented for sign off by the Health & Wellbeing Board but stressed that there might be timing issues in view of the deadlines.

 23.9   Janice Robinson asked what had been done to identify shortcomings in 7 day working so far.  She felt that there probably were important gaps in the hospital system.  She suggested that some of the funding needed to be placed into health to fund these gaps.   She asked to what extent had the local authority and CCG been able to identify the gaps and whether some of the money would have to be provided to health. 

23.10  The Executive Director explained that there were already joint plans and that some of the money was spent on community services.  The Head of Adults Assessment explained that seven day working in hospitals was already in place.  However, the whole sector needed to move to seven day working in order to provide a complete service.    

23.11  Councillor Bowden mentioned that patients were being discharged to their own homes without adaptations.  He asked where the adaptation fund came from.  The Head of Adults Assessment replied that there were a number of different funds and it was critical that people were placed in the right facility when leaving hospital. 

23.12  The Chair stated that the Committee would like to see the plans by January 2014.

23.13  RESOLVED - (1)      That the actions needed to establish the ITF and the issues that it raises be noted.