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Concerns over health targets

'Reluctant acceptance' of new targets to improve delayed transfers of care

County councillors have agreed to ‘reluctantly accept’ new NHS England targets to improve delayed transfers of care.

However, the local authority says it has serious concerns about the ‘actions and attitude’ of NHS England towards financial penalties on performance around the transfers which, if imposed, could reduce the £52m Better Care Fund in the county.

The council is also calling on the Local Government Association and the County Councils’ Network to challenge ministers to ‘prevent further damage to partnership working on health and social care integration’.

Council leader Nick Rushton said: “Local partners in health and social care have a good joint working relationship towards improving delayed transfers of care as set out within our BCF plan, but these relationships, here and elsewhere in the country, are being placed under significant pressure by NHS England  who require us to meet November targets on delayed transfers of care which are set arbitrarily.

"We’ve been put in a position where we, very reluctantly, have to accept this target being imposed, in order to avoid potentially large financial risks, the scale of which has yet to be quantified by NHS England. 

 

It is beyond frustrating that we have been placed in this position given our good performance as an authority on delayed transfers of care. We’re calling for the whole approach to be reconsidered so that partnership working between health and social care in local places is not further damaged.

 

Coun Rushton added: “It is perverse that, in our case, NHS England is threatening to penalise us for delayed transfers of care when they are not attributable to social care, but to NHS trusts.  

"It is also perverse that NHS England would take funds from local authorities and hand them to NHS trusts to purchase their own care, thereby de-stabilising and potentially breaking the market.”

Earlier this year, NHS England published guidance for submissions of Better Care Fund (BCF) plans, which included new requirements for improving delayed transfers of care through new national targets.

The county council is concerned that, if  partners in Leicester, Leicestershire and Rutland do not agree to meet NHS England’s ‘required improvement trajectory’ by November 2017, elements of funding within the £52m Leicestershire budget could be removed as the BCF plan would be graded as ‘not approved’.

Although the specific financial implications on the BCF plan are unclear, at least part of a £22m contribution to protect and sustain adult social care services would be placed at risk this year, said a report to the county council's Cabinet.

The report says: “If any BCF funding is withdrawn at this stage in the year, it will probably move the county council into an overspend position given the impact on the adult social care budget and, if it extends into next year, the position is even more serious given there is already a need to find extra resources to meet an overspend in children’s social care.”

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