By Richard Johnstone | 7 May 2014
The government has insisted its plan to integrate health and social care spending through the Better Care Fund remains on track to be introduced next year despite concerns about implementation.
A spokesman for the Department of Health said the introduction of the £3.8bn pooled spending fund was on schedule after media reports said a launch event, scheduled for last week, was cancelled. A Guardian report claimed this followed Cabinet Office concerns about how the expected savings resulting from integration would be achieved, including what impact finding £1.9bn from hospital budgets would have.
A Department of Health spokesman said successive governments had talked about joining up health and social care, and insisted the Better Care Fund would be a major step towards making this a reality.
‘We have set aside time to make sure all areas have developed comprehensive plans for joined up care,’ he added.
‘The Better Care plans start from April 2015, and we asked for early versions to be completed a year in advance so we could review them, check their level of ambition and test how they would be delivered. This is what is happening now.’
However, the chief executive of the Nuffield Trust said the Better Care Fund was based on ‘flawed logic’.
Nigel Edwards said the plan assumed hospitals could quickly achieve a 15% reduction in emergency admissions through greater integration with local authority care services, and that these reductions would lead to savings in the same year, at full cost.
‘But reducing admissions takes time, and lowering the types of admissions targeted by the Better Care Fund costs money,’ Edwards said. ‘These assumptions are therefore wildly optimistic.’
Given this, the Cabinet Office was right to be asking ‘searching questions’ about the plans, he said.
‘The wishful thinking underpinning the Better Care Fund is more than just an inconvenience. With almost half of all acute hospitals already in deficit, there is a very real danger that shifting £1.9bn largely out of the hospital budget, as this policy proposes, could lead to a widespread financial collapse across the acute hospital sector.
‘Simply expecting efficiencies from hospitals to deliver the savings needed for the fund on top of already very challenging targets is not going to work. Delaying its implementation and focusing on how to get patients home from hospital more quickly should be a priority.’
