London's borough Leaders have been considering how they can play a key role in shaping and supporting health and care reform in the capital - to drive better health and wellbeing outcomes for citizens and more integrated and efficient services.
While exploring the case for devolution of powers and resources to support this, they are committed to making progress on improving outcomes and services within the means already at their disposal.
The Better Care Fund is an important vehicle for driving forward health and social care integration at pace and scale. The detail of how it has worked so far has raised some challenges, but the principle of pooling funding and planning together to deliver joined up and personalised services is sound.
London Councils therefore supports the government's manifesto commitment to continue to integrate health and care, joining up the systems between homes, clinics and hospitals through the Better Care Fund.
The experience of the administrative challenges of the BCF in its first year has taught us the importance of realistic timetables and early, consistent guidance, to enable effective joint local planning and collaboration.
So, we are urging the government to take early action to clarify the approach to the BCF in 2016/17 to give boroughs, CCGs and their partners time to develop ambitious plans to take integration a meaningful step forward in that year.
In July, we called on the government to:
- set out its policy direction for BCF in 2016/17 before the summer
- publish final guidance and timetables by early September
- ensure that plan assurance is completed by early February 2016.
We also set out 8 core design principles that should be adopted as a framework for making the BCF in 2016/17 a further significant step forward in health and care integration, while allowing for flexibility to develop ambitious plans to reflect local circumstances and priorities.
Our core design principles are:
- extend the scope
- make prevention and early intervention a mandatory component of every local plan
- expand the scale by doubling the minimum amount to be pooled nationally 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 conduct monitoring 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
Read more here.