National Audit Office questions the optimism of the Government on the effectiveness of the Better Care Fund

The National Audit Office report has found that the anticipated savings as part of the £5.3bn Better Care Fund have failed to materialise.

The intention of the Better Care Fund was to join up health and social care and avoid the problems that flow from bed blocking. The ambition was to reduce emergency admissions by 106,000 in order to save £171m in 2014/15 and to reduce delayed transfers of care by 293,000 in the same year.  However, the actual figures appear stark.  the report shows that the number of emergency admissions actually increased by 87,000 which lead to an increase in costs by £311m. In addition, the number of delayed transfers of care increased by 185,000, costing an additional £146m.

The report further states that it was questionable whether integrating services in any event would lead to a significant cost saving. £2bn of the Fund had been used to assist Trusts with their substantial deficits.

The report states: –

“A key assumption of the fund – that funding could be transferred from the health sector to social care without adverse impact on the NHS – has proved not to be the case because the health service itself is under financial pressure…  As a result, the fund has not achieved the expected value for money, in terms of savings, outcomes for patients or reduced hospital activity, from the £5.3 billion spent through the fund in 2015/16.”

The report did note that the Fund had led to some soft benefits being experienced, for example, 9 out of 10 of local areas agreed that joint working had improved. Meg Hillier MP, chairwoman of the Public Accounts Committee said of the Funds plans: –

“The committee warned that the focus on reducing emergency admissions to hospital without enough investment in community-based services would increase pressure on adult social care services…  In fact, the number of emergency admissions continues to increase, as does the number of people unable to leave hospital when they are ready to; increasingly because they need homecare or a place in a care home, which are simply unavailable.”

Lessons certainly need to be learned when considering the implementation of transformation projects such as the Better Care Fund in the future. More caution should be given to setting overly ambitious targets in the future.

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