Better Care Fund

The Better Care Fund is a pooled budget, initially £5.3 billion announced by the Cameron Government in the June 2013 Spending Round. Local councils are allowed to increase the local fund. The intention is to shift resources into social care and community services from the NHS budget in England and so save £1 billion a year by keeping patients out of hospital.

Each of the 151 health and wellbeing boards is required to produce a local plan, and these plans are checked by NHS England. Analysis of the plans submitted showed that social care would benefit from the fund by about £2 billion. This is four times the amount projected for hospitals to save from reduced activity.[1]

The National Audit Office said in November 2014 that the plans had been inadequately thought through and were based on “optimism rather than evidence”. There was no evidence that showed that integrated care reduces unplanned hospital admissions.[2]

Francis Maude praised Inclusion Healthcare at a speech in December 2014 about the Fund saying the company could provide care more cheaply and simply than the NHS. He said the fund was unlikely to lift the pressure from overcrowded hospitals because of “endless process and bureaucracy” in the NHS. He related how Inclusion had helped a homeless man with leg ulcers who was refusing to go into hospital because he could not afford to put his dog in kennels while he was there by writing "a cheque for £200 or whatever it cost to have the dog vaccinated and put into kennels".[3] According to Maude, the firm say "actually if we had still been in the NHS we could never have done that without endless process and bureaucracy and auditing and which budget does it come out of, and how do we account for it, and it would never have happened”.[4]

The Chartered Institute of Public Finance and Accountancy and the Healthcare Financial Managers Association surveyed the ambitious plans for saving money through integration financed by the BCF in December 2015 and concluded that 80% were likely to fail and that many were hampering progress, and “giving integration a bad name”. Targets for reduced hospital admission had generally not been delivered.[5]

In February 2017 the National Audit Office produced a report saying that the £5.3 billion spent in 2015/16 had not delivered value for money. Emergency hospital admissions had increased by 87,000 between 2014/15 and 2015/16, rather than the planned reduction of 106,000, which had cost an additional £311 million. Delayed transfers of care increased by 185,000 days, rather than the planned reduction of 293,000, which had cost £146 million more. [6]

References
  1. "Exclusive: Social care to benefit most under better care fund". Health Service Journal. 4 November 2014. Retrieved 23 December 2014.
  2. "NHS facing £700m black hole over failing Better Care Fund". Independent. 11 November 2014. Retrieved 23 December 2014.
  3. "Lessons from the UK: why public servants need space to fail". The Mandarin. 18 December 2014. Retrieved 23 December 2014.
  4. "Tory Francis Maude says NHS reforms hinge on inclusion of private firms". Guardian. 22 December 2014. Retrieved 23 December 2014.
  5. "Four-fifths of areas expect to miss BCF targets, survey finds". Health Service Journal. 7 December 2015. Retrieved 8 February 2016.
  6. "NHS vanguard plans to save £900m by 2020 'optimistic', says NAO". Commissioning Review. 8 February 2017. Retrieved 11 February 2017.


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