Hillingdon Council has approved its participation in a Section 75 agreement with the West and North London Integrated Care Board (ICB) for the 2026/27 Better Care Fund (BCF). The agreement, valued at £76,342,227, aims to enhance collaboration between health and social care services to better coordinate resources and improve outcomes for residents.
The BCF plan, which runs from 1 April 2026 to 31 March 2027, focuses on identifying individuals at risk of escalating needs, supporting independence, preventing hospital admissions, and facilitating safe hospital discharges. Key beneficiaries include older people, individuals with long-term conditions, and unpaid carers.
Specific initiatives funded by the BCF include 'Live Well', which aims to maximize independence and prevent unnecessary hospital or residential care admissions for working-age adults. The 'Age Well' scheme targets those aged 65 and over, also focusing on maximizing independence and preventing admissions. The 'Active Recovery' program promotes recovery and independence after acute illness, while 'Infrastructure Enablers' provide foundational support for operational service delivery.
To identify and prioritize individuals with escalating needs, the 'Age Well' scheme will focus on risk stratification and early intervention within Integrated Neighbourhood Teams (INTs), specifically targeting the 4,400 people who are high users of health services. Residents can anticipate seeing the benefits of this enhanced collaboration throughout the plan's implementation period.
Unpaid carers will receive specific support through the 'Live Well' scheme, which aims to develop their support networks. Additionally, the 'Active Recovery' scheme includes funding for 'Services to carers (including respite)', supplementing existing provisions and addressing inflationary pressures.
The Council's contribution to the pooled budget is £46,674,122, representing existing services and funding aligned with BCF priorities. The NHS contribution totals £29,668,105, with £27,927,934 released to the Hillingdon health and care system, of which £9,564,653 is specifically allocated to Adult Social Care.
Success will be evaluated using key performance indicators (KPIs). For 'Live Well', metrics include the proportion of unpaid carers on the register and long-term admissions to residential care homes for people aged 18-64. 'Age Well' metrics include emergency hospital admissions for those aged 65+ and fall-related admissions, as well as long-term residential care admissions for this age group. The 'Active Recovery' scheme will track the average length of discharge delay for all acute adult patients and the reduction in patients in acute hospitals not meeting the Criteria to Reside (CTR). For 'Infrastructure Enablers', the metric is the increase in the percentage of regulated providers assessed by the Care Quality Commission as 'good' and above.
Potential risks and challenges associated with this integrated care approach are addressed within the Section 75 agreement. Schedule 3 outlines that partners will manage their own risks unless otherwise stated. For overspends in the Pooled Fund, liability rests with the partner whose prescribing team incurred the overspend (Council for Social Care, ICB for NHS Teams), unless the overspend is due to maladministration or breach of the agreement. For underspends, any cash savings delivered in services within the Pooled Fund will be retained by the partner generating the saving. The agreement also includes provisions for managing overspends and underspends in non-pooled funding.
Authority has been delegated to the Corporate Director of Adult Social Care and Health, in consultation with the Cabinet Member for Adults, Children, Health and Care, to amend the agreement's terms during the year as needed.
More information on council agendas and reports can be found in the Public reports pack.