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London boroughs: next steps for integration of health and care

  • By Jim Ranger

Uncertainty around the future direction of the Better Care Fund (BCF) could put at risk large-scale health integration during the life of the current parliament, according to London Councils.

The body, which represents the 32 boroughs and the City of London, is urging the government to set a clear direction before the summer for how the BCF will be managed in the financial year 2016/17 to allow boroughs and their partners to plan ahead.

The Fund was announced in June 2013 to drive the transformation of local services with the aim of providing better and more integrated care and support. Money from the fund is deployed locally through pooled budget arrangements between local authorities and Clinical Commissioning Groups and plans agreed by Health & Wellbeing Boards.

Councillor Teresa O’Neill OBE, London Council’s Executive member for health, said: “London’s boroughs are committed to playing a positive and collaborative role in reforming health and care in the capital. Integration of health and care is central to achieving lasting reform, and building on existing success is a key part of this process.

"Despite BCF being dogged by administrative challenges, London Councils continues to support the Better Care Fund as a vehicle to drive forward integration. The principle of pooled funding and joint planning between local government and health is sound and has achieved pooling of £5.3 billion of NHS and social care funding to date.

“However, we believe the government has to act before the Comprehensive Spending Review (CSR) to clarify what direction the Better Care Fund should take in 2016/17. Delay could undermine our achievements and will limit the potential for further progress next year.”

London Councils has identified eight core principles for how the BCF should evolve in 2016/17, including extending the scope and scale of the fund, making prevention and early intervention a mandatory component and ending the nationally-mandated ‘payment for performance’ target.

Cllr O’Neill added: “One of the lessons so far has been the need for sensible timetables and clear guidance to give local partners time to work up collaborative plans. London Councils believes there is a danger of the process stalling during the next financial year unless the government provides clear and timely direction that sets out its ambitions.”

ENDS

Notes to Editors

London Councils’ Core Design Principles for the Better Care Fund in 2016/17 can be found at http://www.londoncouncils.gov.uk/node/26600 

London Councils’ eight core design principles are:
•    Extend the scope
•    Make prevention and early intervention a mandatory component of every plan
•    Expand the scale by doubling the minimum amount to be pooled national from £3.8 billion in 2015/16 to £7.6 billion in 2016/17
•    Local BCF and sub-regional operational resilience planning should be aligned by including operational resilience funding in the BCF pooled budget
•    End the nationally mandated payment for performance target
•    Strengthen alignment of commissioner and provider plans
•    Reduce bureaucracy and monitor intelligently
•    Require local areas to submit a roadmap of how they will move towards full integration of health and care by 2019/20 at the latest, alongside their BCF plan for 2016/17.

London Councils has urged the government to set out its policy direction for BCF 2016/17 before the summer, publish final detailed guidance and timetables by early September and ensure that plan assurance is completed by February 2016.

Government set a minimum of £3.8 billion for the BCF pooled budget in 2015/16. Some areas chose to pool more – hence the national total for the BCF pot for 2015/16 of £5.3 billion.