Agenda item

To provide an overview of the Better Care Fund (BCF) and the Health and Wellbeing Board’s role in ratifying the BCF.

Eleanor Maxwell provided an overview of what the Better Care Fund was and its mechanisms to new Board members before they were asked to ratify the end of year position and plan for 2026-27. In outlining the purpose of the Better Care Fund, she highlighted that it underpinned the services residents relied on, particularly in relation to the move between hospital and the place the patient called home. There were many strands of governance to the Better Care Fund (BCF), for which the Health and Wellbeing Board provided strategic oversight and democratic accountability. Every area in England was required to produce a BCF which then acted as a joint agreement between the local authority and ICB and was supported by a Section 75 Agreement. Whilst based on guidance, every BCF was local to the area it sat within, meaning Brent had the ability to chose how BCF funds were spent in the borough and there was a good amount of flexibility within that. In terms of the purpose of the BCF, she advised that it enabled the local authority and ICB to jointly plan services by bringing funding together to focus on shared priorities based on the needs of residents.

Over the last three years, she had helped to significantly strengthen the way Brent managed the BCF with stronger monitoring of metrics and stronger governance. A full corporate audit had been undertaken with all recommendations now implemented and a dedicated BCF Board had been established to improve financial monitoring and scheme management. The stronger, more robust approach to measuring performance and outcomes had strengthened partnership working, giving greater visibility of where the investment was having the greatest impact and enabling partner to move much faster where gaps needed to be addressed.

Eleanor Maxwell flagged that, over the next two years, there would be a need to respond to significant national changes, including the ICB restructuring, the development of a system integrator role, and the transition following the abolition of NHSE who currently owned the BCF. Whilst this would present challenges, she felt that there would also be opportunities to strengthen local partnership working to further align services around neighbourhoods.

Looking ahead, the BCF would continue to play a central role in supporting the shift towards neighbourhoods, and the key existing metrics were likely to remain unchanged. Whilst reducing hospital admissions and improving discharge were still priorities, there was an increasing focus on prevention, early intervention and supporting people to remain independent in their own communities. The BCF would increasingly align with the development of neighbourhood working, meaning using shared resources and flexibility, designing services around people’s needs rather than organisational boundaries and making greater use of shared data and joint decision making. Success would increasingly be measured not only by how quickly people leave hospital but whether they were able to live healthier and more independent lives and avoid unnecessary escalation into intensive services. In practical terms, she flagged that the greatest challenge would be balancing the need to sustain existing services with the expectation to invest in new models of care, which would be difficult if the funding did not keep pace with inflation, or if there were demographic changes or rising demand where Brent was expected to do more with less.