Agenda item

This report explores the three previously identified options for the future provision of the Disabled Facilities Grant programme and the wider Better Care Fund initiatives within Tonbridge & Malling B.C. Dependent on the option chosen by Members there may be future financial implications for the Council and an analysis of this is provided for each option.

The Hospital Discharge Manager, Maidstone & Tunbridge Wells NHS Trust (Dawn Hallam) and the Occupational Therapist lead at Kent County Council (Jane Miller-Everest) will attend to present their views and answer any questions raised by Members. 

The report of the Director of Planning, Housing and Environment Health outlined a number of options for consideration regarding the future provision of the Disabled Facilities Grants (DFG) programme and the Better Care Fund (BCF) initiatives within Tonbridge and Malling.  Funding for these services and mandatory DFGs was awarded annually through the Better Care fund.   Unfortunately, forward planning for services and budgets was challenging as the funding announcement was not made until the end of March and actual spend was demand led.

It was also reiterated that DFGs were a mandatory grant that the Borough Council had to administer through the Housing Grants, Construction and Regeneration Act 1996.

Representatives from the Maidstone and Tunbridge Wells NHS Trust and Kent County Council Occupational Therapy shared their experiences of the West Kent Hospital Discharge Scheme and the secondment of an Occupational Therapist (OT) into the Borough Council’s Private Sector Housing Team.    A number of options to improve the ability to recruit into vacant OT posts and to enable the ongoing delivery of DFG assessments in a timely manner were outlined by Kent County Council.

Members recognised the value to residents of the initiatives delivered by the Better Care Fund and the Hospital Discharge Scheme which offered patients the opportunity to return to a safe home environment. This in turn created space in hospital wards.  In addition, Members recognised that the OT secondment initiative had been successful in reducing waiting times for DFG assessments and were keen to retain this service if possible.

However, the Borough Council continued to face significant financial pressures due to the ongoing reductions in Government funding.   As a result, there was in-depth discussion as to whether it was the role of the Borough Council to deliver this programme of work, other than the mandatory obligations, and whether the NHS Trust should provide a greater funding contribution.

The Director of Finance and Transformation explained that the funding provided through the BCF was now insufficient to meet both the mandatory grants and the ‘discretionary’ programme of initiatives which the Borough Council had been successfully operating.  It was expected, all other things being equal, that it would be necessary to provide £125,000 of Borough Council funding to ‘top up’ the BCF allocation for mandatory grants.  Therefore, continuing to run the initiatives would be a further cost which was not factored into budgets across the Medium Term and would increase the funding gap, unless Members identified an alternative option that could be reduced immediately to compensate.   It was noted that six months funding from the Housing Assistance Reserve had been factored into the draft Budget for the initiatives in 2020/21.  This meant that there was a short period for a further review to be undertaken into funding opportunities and service provision.  

Members acknowledged that the Private Sector Housing team and Health team (on behalf of the Borough Council) delivered excellent services for the benefit of residents for both the One You and Better Care Fund initiatives. 

RECOMMENDED:  That

(1)  a decision regarding the future provision of the Disabled Facilities Grant programme and Better Care Fund initiatives within Tonbridge and Malling be deferred so that:

-       a formal request for funding be made to Maidstone and Tunbridge Wells NHS Trust for a contribution towards the hospital discharge service; and

-       the impact of the options for the OT service within Tonbridge and Malling Borough Council, presented at the meeting by Kent County Council, could be further explored.  

(2)   A report setting out these issues in more detail to be reported to a future meeting of the Overview and Scrutiny Committee.