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Government's £3.8bn integrated care fund 'lacks credibility', reports claim

A Cabinet Office report has found the Government’s flagship £3.8 billion fund to integrate health and social care ‘lacks credibility’, according to newspaper reports today.

However, the Department of Health was quick to dismiss reports that the implementation of the ‘Better Care Fund’ - which the Government has indicated could be used to help boost investment in primary care - was to be delayed from its planned start date of April 2015.

It added that CCGs were told to develop plans for how they would spend the pot in tandem with local authorities by March 2014.

The fund provides a pooled budget for CCGs and local authorities to promote integrated health and social care and includes £1.9bn from existing ‘NHS allocations’, which critics have said would have to come from secondary care efficiency savings.

But the reports, in the Guardian, had suggested this has been put on hold following a Cabinet Office review, which - the paper claims - found there was ‘little or no detail about how savings would be delivered’ and that hospitals had not been consulted on plans to spend the money.

The newspaper says that a joint group from the Cabinet Office and Department of Health have been tasked with producing extra evidence to make the scheme ‘credible’ and overcome Cabinet Office scepticism.

The Guardian cites a Whitehall source as saying the plans that had been submitted so far had failed to ‘show in detail where savings will be achieved’ or that hospitals will be able to reduce their spending.

The Guardian’s source states: ‘The Better Care Fund is based on the idea that if you invest to build up services outside of hospitals based on integrated care, that will help you to ultimately save money from the hospital budget. But the plans produced so far don’t show in detail where savings will be achieved as a result of the investment, or that hospitals will be able to reduce their spending.’

‘Because they don’t, the Cabinet Office don’t think the plans produced so far are credible enough and don’t have enough information in them about how the savings will be made, or detailed enough forecasts.’

However, the DH has said the fund was continuing as planned. In a statement, it said: ‘Successive governments and leading health professionals have talked about joining up health and social care for decades - the Better Care Fund is a major step to making this a reality and transforming the way people are cared for closer to home.

‘We have set aside time to make sure all areas have developed comprehensive plans for joined up care. 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.’

Pulse revealed in September last year that health minister Earl Howe said NHS managers were looking at how the fund could be used to help boost investment into primary care.

The King’s Fund has cast doubt on whether these efficiencies could be made, saying emergency admissions would have to drop by 15% to achieve it.

The think-tank’s report last week said the NHS was approaching a financial ‘cliff edge’ and that ‘on its current trajectory the health and social care system in England is rapidly heading towards a major crisis’.

Readers' comments (2)

  • Vinci Ho

    (1)No new money but the government is willing to keep corporation tax low to let foreign companies (e.g.US) to come in. Trans- Atlantic trade treaty is to open the door wider. Keeping that tax low by all means may 'benefit' private sectors but goes with the 'commitment' of funding less and less in sector like NHS.
    (2)'if you invest to build up services outside of hospitals based on integrated care, that will help you to ultimately save money from the hospital budget'. This becomes a slippery slope fallacy if one is to stifle and strangle the neck of secondary care. Primary and secondary care will become even more antagonistic to each other.
    (3) The whole thing is inevitably driven by partisan politics . Democratic? Responsible? Ethical?

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  • Hi Alex,
    Last year, Mr Lamb chose 14 "pioneers" out of hundreds of candidates to lead a "quiet revolution," to use the Minister's words. He identified them as "real leaders" in driving integration.
    Any news on the pioneers' performance so far and their fate?

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