Agenda item

The Board considered a report of the Director of Adults and Communities which provided the year-end performance reporting of the Better Care Fund programme for 2024-25. A copy of the report, marked ‘Agenda Item 11’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)           For each Better Care Fund metric there were targets which were set for Leicestershire. Performance in Leicestershire could be compared with other authorities for each quartile. Care was taken to set realistic targets as there was no point setting a target that had no chance of being achieved.

(ii)         The rate of admissions per 100,000 population was above target and it was hoped that additional investment in neighbourhood models of care and step-up activity would mitigate the increase seen in the financial year. In response to concerns raised that the neighbourhood work would take time to implement and have an impact, it was explained that in the meantime consideration was being given to revising the falls response service. For 2025/26 an estimate had been made of how many admissions would be reduced by each measure put in place for example the introduction of virtual wards.

(iii)        The metric ‘Emergency hospital admissions due to falls in people aged 65 and over directly age standardised rate per 100,000’ had met the target. In order to achieve this a lot of work had taken place with care homes, particularly the top 20 care homes for admissions, to help them avoid having to send residents to hospital. Efforts were made to ensure the care homes had the right equipment and technology so that residents could be managed within the care homes and did not suffer injuries that required hospital treatment.

(iv)       Work was also taking place to ensure that the Emergency Department at Leicester Royal Infirmary had the ability to refer patients into community pathways rather than having to admit them into the hospital. The Single Point of Access was also being strengthened.

(v)         Concerns were raised that not all care home staff were trained to assess residents after they had a fall and therefore it was suggested that care homes were erring on the side of caution and sending those residents to hospital when it might not be necessary. Adult social carers were advised not to lift residents if they had fallen, unless they had received specific training. However, staff from the falls car were able to triage residents that had fallen and were clinically competent to lift people. It was acknowledged that if attendances at the Emergency Department could be avoided then in turn admissions would be reduced.

(vi)       Concerns were also raised that falls patients were classed as low priority and therefore received a category 4 ambulance response which meant that the ambulance staff sent to the scene were not trained to the level of paramedics and were not able to judge whether the patient required attendance at the Emergency Department. In response some reassurance was given that a piece of work was taking place to ensure that category 3 and 4 calls could be diverted to the Home Visiting Service.

RESOLVED:

a)  That the performance against the Better Care Fund outcome metrics, and the positive progress made in transforming health and care pathways in 2024-25 be noted;

b)  The year-end Better Care Fund 2024-25 template, attached as the appendix to the report, be approved for submission to NHS England for the 6th June, 2025 submission deadline;