Better Care Fund

In support of the Government’s policy of integration, and in addition to launching 14 Integrated Care Pioneers’, a £3.8 billion Better Care Fund is being established for 2015/16.

This funding is not new investment but brings together existing NHS and Local Government resources already committed to existing core activity. By channelling the funding through Health and Wellbeing Boards it is intended that the Better Care Fund acts as a catalyst for agreeing a joint vision of how integrated care will improve outcomes for people. An important planning condition is that all local providers of health and social care likely to be affected by the Fund are engaged in the planning process.  

The Better Care Fund creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services.

A breakdown of the funding for 2015/16, shown below, includes the Disabled Facilities Grant (DFG) worth £220m. To help localities prepare for the full Better Care Fund in 2015/16 an extra £200m has been transferred from the NHS to social care this year, in addition to an original £900m planned transfer.

In 2015/2016 the Better Care Fund will be created from the following

£1.9bn NHS funding

£1.9bn based on existing funding in 2014/15 that is allocated across the health care systems. Composed of:-

  • £130m Carers’ Breaks
  • £300m CCG reablement funding
  • £354m capital funding (including c£220m of Disabled Facilities Grant
  • £1.1bn existing transfer from health to social care

Many areas have confirmed their intention to add significantly to this pot by pooling additional resources locally to support the introduction of more integrated support services.

Health and Wellbeing Boards are required to sign off a two year operational Better Care Plan for their constituent local authorities and Clinical Commissioning Groups, in line with their wider five year strategy for health and social care.

These plans were originally submitted in March 2014, setting out how the pooled funding will be used and the ways in which the national and local targets attached to the performance-related £1 billion will be met. However, in June 2014 ministers agreed that £1 billion of the NHS additional contribution should be restricted for services either commissioned by the NHS on out of hospital services or be linked to a corresponding reduction in total emergency admissions. Localities were therefore asked to revise their plans to reflect this whilst ensuring protection of social care remains a top priority, and the revised plans must reflect this clear policy intention. Revised plans had to be submitted by 19th September.  Full guidance and templates are located on the NHS England website.

In principle the Better Care Fund must ensure

  • all plans are jointly agreed;
  • social care services (not spending) are protected;
  • 7-day working in health and social care to support patients being discharged and prevent unnecessary admissions at weekends;
  • better data sharing between health and social care, based on the NHS number (it is recognised that progress on this issue will require the resolution of some Information Governance issues by the Department of Health;
  • a joint approach to assessments and care planning;
  • an accountable professional is allocated for all funded integrated packages of care,
  • a risk-sharing principle and contingency plans if targets are not met – including redeployment of the funding if local agreement is not reached;
  • agreement on the consequential impact of changes in the acute sector.

5 localities have already been fast tracked though the approval process and their agreed plans have now been published. Full details of the 5 locations and the jointly approved plans can be found here.