The Better Care Fund is a pooled budget for health and social care spending in the city which is shared between NHS Sheffield Clinical Commissioning Group and Sheffield City Council. This set of slides talks Health and Wellbeing Board members through plans for the Better Care Fund in 2016/17. The slides were presented at the Health and Wellbeing Board meeting on 31 March 2016. The paper which supports these slides can be read and downloaded at: http://sheffielddemocracy.moderngov.co.uk/ieListDocuments.aspx?CId=366&MId=5996&Ver=4.

1. Better Care Fund 2016/17

2. • Recap and reflection on 2015/16
• Understanding the problem
• What did the people of sheffield say
• A single city vision
• Engaging the whole system
• Key areas of work for 2016/17
• Questions / feedback
Contents

3. • 2015/16 BCF £270m
– One of the largest in England (min commitment is £40m)
– National influence
– 2015/16 learning
• Its difficult work.
• Barriers – statutory / organisational / cultural /
professional / populations served etc.
• Providers didn't feel part of this process.
• But … all stakeholders across the City are up for this.
Recap and reflection on 2015/16

4. Understanding the needs of our
580k population
The gap in life expectancy between the most and least deprived men in
Sheffield is 9.8 years and 6.9 years for women – no change for 10 years!
25-30% of people admitted to hospital have a mental
health condition which in many cases isn't treated..
The causes in life expectancy between least and most deprived in sheffield:
Men - Cancer 32.1%, Circulatory disease 27.3%, Respiratory Disease 13.5%,
Women – Cancer 35.6%, Respiratory Disease 21.5%, Circulatory disease 19.5%,
People wait too long for emergency and elective
care – outside of national standards.
The CCG allocation uplift for 2016/17 was 2.2% National
average 3.4% - 0.8% in real terms
The assessed combined efficiency challenge across the health
and social care system taking into account demand pressures,
tariff efficiency, trust stretch CIP targets, other loss of income is
£96m, leaving a net efficiency challenge of £75m.
Sheffield City Council required to find £50m savings this year.
£50m delivered last year.
We know we have a financial problem
We know what contributes to our poor outcomes in health inequalities
We know where are services do not provide support and care at the standards people expect.
The care they do receive does not deliver the
outcomes other health systems enjoy.
The gap in healthy life expectancy is a gap of 22
years for men and for women a gap of 22.5
years between the most and least deprived

5. What do the people of Sheffield say?
I find it hard to find my
way around all the variety
of services – or even to
know if what I need is
actually provided by
someone
I have little control
over the care I do
or don’t receive
My psychological
needs are not met
as part of care for
my physical needs
Services often aren’t
available at night or
weekends like they
are during the week
Why don’t services plan in
advance – surely they should
know if I get unwell I’ll
struggle to cope but don’t
necessarily want or need to
go into hospital
Why can’t I just
have one care
plan?
If things go wrong
it’s difficult to
receive the care I
might need quickly
enough
We have to
constantly repeat
information from
one person to
another

6. Single Sheffield City View
Focus on health and wellbeing
inequalities
Financial sustainability for the
system
Integration and
integrated care
pathways
Alteration of
contracting
mechanisms
across system
Collaboration
with partners
Workforce,
technology, etc.
development
There is consensus across the city from all key parties that there are six principles
to deliver by 2020

7. Engaging the whole system
- Fewer meetings
- Local Clinicians leading delivery
- Working for the whole systems benefit
- Commissioner led Service Transformation
structure- we set pace and scale
- Patient Centred solutions
- New rigour of delivery
- Organisationally agnostic
… to deliver!

8. A detailed action plan
Theme
1. People Keeping Well/Ongoing Care
2. Servicing neighbourhoods
3. Developing primary care
4. Urgent and reactive care
5. Effective care/planned care
6. Mental health
7. IT/Information Governance
8. Estates
9. Workforce/OD
10.Research and evaluation
Actions
1. Reduce numbers and cost of high
activity of people with whole-life conditions
2. Agree a single assessment
process/reduce assessment
3. Where appropriate redeploy staff
duplicated through development of a single
team to then deliver a faster assessment at
six weeks reducing their level of support
required
4. Transforming Care Action Plan
5. Implementation of the second phase of
People Keeping Well
6. Voluntary sector to standardise social
prescribing offer across all practices
7. Fire service extension of home visits
8. Trial of expanded scope of health check
visits to include sight tests and exercise
routines etc.

9. • People Keeping Well
– Local Advice and Information
– Risk stratification
– Community Assets / Activities
– Life Navigators
– Wellness planning
Key areas of work for 2016/17

10. • Active Support and Recovery
– Provide packages of care to enable patients to
stay at home
– Establish GPs working in groups to release more
time to proactively plan care for complex patients
– Agree escalation plans with patients to mean they
are able to better prevent escalation of their
condition
– Improve the coordination of post acute discharge
support.
Key areas of work for 2016/17

11. • Ongoing Care
– Deliver an integrated process of assessment of
ongoing care need across health and social care
– Simplify the administration of care packages
which will enable a culture change and more joint
assessments
– Develop a new assessment process which
supports patients in hospital and allows discharge
based on health need.
Future models of care

12. • We want feedback.
• We need to be ambitious
• Does what is proposed do what is
required?
Questions