Better Care Fund struggling with red tape, CIPFA warns

7 Dec 15
The flagship government project to bring health and social care funding together is being hindered by red tape that must be tackled if services are to be integrated, a CIPFA report has found.

In an examination of the £5.3bn Better Care Fund with the Healthcare Financial Management Association, CIPFA found the project, which was introduced this year, is leading to improved working relationships between NHS bodies and other local public services.

However CIPFA chief executive Rob Whiteman said an examination of around one third of the 151 Better Care Fund plans revealed a need to simplify administration to deliver a meaningful impact.

The BCF has pooled £5.3bn in the current financial year as part of plans to integrate health and social care.

The report looked at 48 plans, representing £3.6bn of the total BCF pool, and found many experiencing an improvement in dialogue across local public sector bodies.

However, respondents highlighted that governance arrangements are complicated due to the numerous clinical commissioning groups and local authorities required to take part and other stakeholders, such as NHS providers. Arrangements in areas with unitary authorities tend to be simpler, the review found.

In addition, there is no single agreed method of setting up and accounting for the flow of funds pooled in the scheme, leading to concerns about the flow of cash between NHS bodies and local authorities and, in particular, the impact on CCGs’ cash management requirements.

As a result, CIPFA and HFMA urged ministers to simplify and streamline the administrative and monitoring arrangements of the BCF prior to 2016/17, and also called for “maximum synergy” between BCF and the government’s devolution programme. Increased localisation of NHS funding to allow for mergers with social care, such as the deals agreed with Greater Manchester and Cornwall, could provide the most sustainable model for taking forward integration at scale, the report concluded.

“Government must do more to support effective governance of the Better Care Fund,” Whiteman added. “This is a real opportunity to get health and social care working together – focusing on prevention before cure – saving lives, time and money.”

HFMA director of policy Paul Briddock added: “It’s positive that the report shows in just six months of the Better Care Fund being put in place, organisations are already beginning to integrate services and collaborate more. What is now needed as a next step, is for targeted streamlining and simplification of processes to take place.”

• Download the report: Better Care Fund - six months on

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