New restrictions on Better Care Fund cash

Better care fund cash will be used to compensate acute hospitals if local integration initiatives do not generate a reduction in emergency admissions, the DH and Department for Communities & Local Government have announced.

The change has been announced following fears from the NHS provider sector as well as NHS England that it would be placed at financial risk if the fund did not lead to lower hospital admissions.

The modifications to the Better Care Fund mean that money will be held back as performance-related payments, which will depend on local area's ability to reduce accident and emergency admissions. If local plans are successful and the savings achieved, the money will be released to local areas to be spend on integrated care, if not the money held back will be used to pay for it.

Richard Humphries, assistant director for policy at The King's Fund, said the announcement had "the potential to drastically reduce councils' options when setting social care budgets", because "many were planning to use the fund to protect social care services."

He said: "This announcement is a sign of growing anxieties within government as the NHS heads towards a financial crunch in 2015-16.

"The better care fund is well intentioned but with no new funding, it is papering over the cracks of deteriorating NHS finances and social care budget cuts."

A senior local government figure has said: "This moves the fund away from being about integration to being about managing risks in the NHS.

"Exactly how much of a risk this creates for councils will depend on local circumstances and relationships. But in the worst case scenario, if the [A&E] target is missed, it will mean less money is available for social care.

They said the measure would disrupt local areas' plans, forcing them to review the plans that they submitted to the DH in spring.

Meanwhile, the DH has also said today that 80% of better care fund plans were on target to significantly improve local services through integrated care.

Health secretary Jeremy Hunt said: "Local authorities and the NHS are making excellent progress in developing plans that will give patients better, joined up care and allow hospitals to focus on treating the people who really need to be there. The plans are packed full of ideas and show that strong partnerships are being forged with different teams like never before.

"Successive governments have talked about bringing the NHS and social care together for decades - this is the first, transformative step to making that a reality. We will continue to nurture and support the development of these plans to deliver our shared ambition so that every part of the country provides better care for patients closer to home."

Simon Stevens, the chief executive of NHS England, said: "This marks an important step in ensuring more joined-up community health and care services for some of our most vulnerable citizens, and we will now be working closely with our partners in local government and the local NHS and many others to ensure the rigour of the local planning matches the scale of the transformation we all want to see. The NHS will widely welcome this collaborative approach."

This is an edited version of an original article which appeared in the Local Government Chronicle (behind a paywall)