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Integrated care budgets ‘to be linked with performance’

CCGs will have part of the £3.8bn shared budget to boost the integration of health and social care held back unless they meet targets, it has been revealed.

A letter from NHS England and the Local Government Association sent this month reveals part of the new pooled budget with local authorities ’ will be linked to performance’ in areas such as emergency admissions and user experience.

The ‘integration transformation fund’ was announced in the Government’s June spending review and CCGs and local authorities have until March 2014 to apply for the funding.

The money will be reallocated from current budgets and ministers have said that they are looking closely at how it could be used to boost investment in primary care, after a plea from the RCGP.

The letter says that the details are still being looked at, but local authorities and CCGs are likely to be measured on their performance in delayed transfers of care, emergency admissions, the effectiveness of re-ablement, admissions to residential and nursing care, and patient and service user experience.

It said: ‘The Government has made clear that part of the fund will be linked to performance. We know that there is a lot of interest amongst CCGs and local authorities in how this ‘pay-for-performance’ element will work. Ministers have yet to make decisions on this.’

It added:  ‘When levels of ambition are set it will be clear how much money localities will receive for different levels of performance.

‘In the event that the agreed levels of performance are not achieved, there will be a process of peer review, facilitated by NHS England and the LGA, to avoid large financial penalties which could impact on the quality of service provided to local people.’

Half of the pay-for-performance element would be paid out at the beginning of 2015/16 as long as Health and Wellbeing Boards have adopted a plan that meets the Government national conditions by April 2014, and would be based on their 2014/15 performance against the metrics.

The remaining 50% will be paid in the second half of the year and could be based on in-year performance.