Funding for health and social care integration

​The Better Care Fund is a national, locally-led policy initiative designed to accelerate the integration of health and social care.

It requires local authorities and the local NHS to pool budgets and work closely together to improve the quality of care for their local population. For the public, it means better, more co-ordinated care and less time spent in acute settings; for the system, it means more efficient public services; and for those that work in the system, it means more time delivering care rather than negotiating organisational barriers.

Too many people end up in hospital who don’t need to be there. Better Care is about getting the care people need, when they need it – not getting passed from pillar to post. It’s about keeping people at home or getting them home from hospital more quickly with the dignity they deserve.

This is all the more important in the context of an ageing population, and a health and care system that is helping people with increasingly complex needs and multiple conditions. We need to move away from a ‘sickness service’, and towards a joined-up health and care service that helps people to manage all aspects of their own health and wellbeing while living independently in their communities for as long as possible. People deserve the right care, in the right place at the right time.

Why is the Better Care programme needed?

An ageing population means that more people will be living for longer with more varied health and social care needs, if we do nothing this will place additional strains on resources that will only grow over time.

Successive governments and leading clinicians have talked about the importance of joining up health and social care for decades. This is a real opportunity for radical change at scale and pace so patients receive the right care, in the right place at the right time. It is an opportunity to make the best use of the resources that are available.

Who is in charge of the Better Care programme?

The changes are being locally led. With local Clinical Commissioning Group(s) we have worked together to produce a plan for local service integration. The plan has been signed off by the local Health and Wellbeing Board, checked against a number of nationally set outcomes and targets, and scrutinised by NHS England and the Local Government Association, before undergoing a Ministerial assurance process.

When does it finish?

The Better Care Fund runs for 2015/16, but pooled budgets are likely to be an enduring part of the health and care landscape for the foreseeable future.

The Better Care Fund will support local areas to take important steps towards joined up health and care, but this is only the first step. Pooled budgets in every area in 2015/16 will light the starting paper for greater integration of budgets between Local Authorities and Clinical Commissioning Groups.

Is the Better Care Fund new money?

The Better Care Fund is a pooling of existing money, rather than new money. It is designed to incentivise and help local areas to use existing funding more efficiently, while delivering better outcomes for the public.

What will the Better Care Fund be spent on?

Local areas decide how their pooled budget is spent. However, there are conditions associated with how some of the money can be spent. For example, some funding is related to the number of people that are successfully kept out of hospital; it can only be spent on certain kinds of services if the local area meets its target on this front.

In line with NHS reforms, this is about putting local commissioners in charge of decisions to deliver care for local people on the basis of local needs, while meeting high level ambitions that are set for the system nationally. Central government has set out what it expects local integration plans to achieve, but has left how this will be achieved to local commissioners who can design services around their local populations.