Mixed news for the Better Care Fund


Recent announcements on the Better Care Fund have made for mixed news.

The biggest positive has been the confirmation that the BCF will run for at least the remainder of this parliament.

A further positive is that the minimum size of the BCF will increase from the current £3.8bn to £5.3bn by 2020 – an extra £1.5bn. And this increase will not be top-sliced from CCG budgets.

On the other hand, this is back-ended money: no increase in 2016/1, £105m in 2017/18 and reaching £1.5bn only 2019/20. Given that the purpose of the Fund is largely to invest up front to improve the longer term position that is unhelpful. Moreover, a good chunk of it is funded from an existing local government source, i.e. £800m from reduced availability of New Home Bonus for local authorities.

There have been widespread calls for the bureaucratic / administrative burden of the BCF to be reduced, and the 2016/17 Better Care Fund Policy Framework moves encouragingly in this direction:

  • Removal of the awkward and over-ambitious £1bn payment for performance framework
  • Sensible-sounding new conditions focussed on funding NHS commissioned out-of-hospital services and tackling delayed transfers of care
  • Appropriate requirements to demonstrate the joint nature of planning
  • A declaration that a reduced amount of finance and activity information will be collected
  • Flexibility for devolution sites, in line with the positive moves towards fuller integration by 2020.

The Policy Framework, published on 4 January, stated that ‘further detailed guidance will be issued by NHS England’ with an original expectation this would be in a matter of days.

However, that was not issued until 22 February, well after the Government’s own original timetable for submission of plans:

  • First draft – 8 February 2016
  • Refresh – mid-March 2016
  • Final submission (signed off by Health and Wellbeing Boards) - mid-to-late April 2016

In view of that, the timescales for submitting Better Care Fund local plans will need to be reset, and there is a danger that local authority and health partners will be less able to plan and consult properly to ensure the best use is made of the BCF in 2016-17.

Mixed news, then, so far – but with scope for positive outcome.