Report criticises Better Care Fund planning

A report released today by the National Audit Office (NAO) has criticised the implementation of the Better Care Fund with the planning process being branded as a “shambles.”

The Better Care Fund, announced by the government in June 2013, is a £3.8bn pooled fund intended to ensure a transformation in integrated health and social care.  The fund is one of the most ambitious programmes ever introduced across the NHS and Local Government.  It creates a single budget to incentivise the NHS and Local Government to work more closely together, placing people’s well-being at the centre of health and care services.  The government’s aim is for the fund to become an enduring part of the health and social care system.

Head of the NAO, Amyas Morse, said “The better care fund is an innovative idea but the quality of early preparation and planning did not match the scale of the ambition.”

Although the report makes a number of positive remarks about the fund, the implementation has been criticised for not having a central programme team, limited risk management, and no analysis of local planning capacity, capability or where local areas would need additional support.  The report states “the departments and NHS England therefore underestimated the complexity and challenge of bringing together the different health and social care organisations around a single local vision in a relatively short time period.”

Other criticisms include the fact that there is limited evidence available to show that integrated care is effective in reducing admissions sustainably, improving outcomes for patients and saving money, suggesting that current figures for savings may be over-optimistic.  The Report also highlights that the changes to the fund announced in July 2014 reduced the time for local preparation, for example workforce planning and training staff, from 11 months to five months.

Chair of the Commons public accounts committee, Margaret Hodge, said she was “dismayed that planning for the better care fund has been such a shambles.”  She accused the government of “incompetence” that was “unacceptable at a time when the number of people most likely to need care is rising, and overall funding is falling.”

A spokesperson for the government said it disagreed with the criticisms stating “this is the most ambitious plan to transform care ever undertaken and we ensured detailed work took place a year ahead of the launch to allow us time to iron out the issues that the NAO itself now acknowledges have been addressed.” 

She added “We welcome this report’s conclusion that the Better Care Fund is an innovative programme providing better, more joined up care to help older vulnerable people stay at home with dignity and independence.  Local areas’ plans show how they will transform services to cut around 160,000 emergency admissions just next year and help people get home from hospital more quickly when they do have to be admitted.  Last month over 97% of local areas had their plans approved, ensuring that people will be able to get seven-day care services that work for them and saving an estimated half a billion pounds of taxpayers’ money too.”

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