Better Care Fund

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The Better Care Fund (BCF) is a critical part of health and care organisations' two-year operational plans, five-year strategic plans, and local government planning. Here, we provide a summary of the key changes to the BCF for 2016/17.

Do these changes address your concerns? Please email Eleanor.Pearce-Willis@nhsconfed.org to share your views and influence our work and activities.

Further details on how the BCF fits with the 2016/17 planning process can be found on our 'Planning for transformation' section.

Statutory and financial basis

  • The total Better Care Fund will value £3.9 billion in 2016/17. This is in line with our requests that the mandatory minimum pool should stay steady, allowing local areas the freedom to increase local pools at the pace that is best for them.
  • £3.519 billion will be taken from NHS England’s allocation to clinical commissioning groups (CCGs) to establish the fund.
  • A further £294 million will be contributed to the Fund from the Disabled Facilities Grant to local authorities.
  • £2.519 billion of the fund will be available upfront to health and wellbeing boards (HWB) to spend on their local BCF plans.
  • The remaining £1 billion will be subject to national conditions.
  • Allocations will be made on a similar basis to 2015/16, using a mixture of the existing CCG allocations formula, the social care formula, and a specific distribution formula for the Disabled Facilities Grant element of the Better Care Fund.

Conditions of access

  • As in 2015/16, BCF funds will be released into pooled funds established under Section 75 of the NHS Act 2006.
  • HWBs must jointly agree plans and sign them off at local level.
  • There are now specific requirements that the plans demonstrate several national conditions; maintained social care provision; seven-day services provision to prevent unnecessary non-elective admissions; better data sharing; a joint approach to assessment and care planning; agreement on impact of changes to some providers; agreement to invest in out-of-hospital services; agreement on a local action plan to reduce delayed transfers of care.

Assurance and approval of plans

  • Assurance and approval processes will be markedly different in 2016/17, with a regional approach to moderation and assurance, and a focus on integrating the process with the rest of local planning. This follows feedback from the Confederation that the previous process was excessively bureaucratic and aligned poorly with other planning processes.
  • After local level HWB sign off, brief narrative plans will be submitted to regional teams and scrutinised by NHS England Directors of Commissioning Operations and regional local government leads
  • Plans will be judged ‘approved’, ‘approved with support’ or ‘not approved’, based on a judgement of their plan quality and risks to delivery
  • Devolution sites may be permitted to submit plans over a larger footprint.

Performance metrics

  • Local areas will be expected to maintain progress against 2015/16’s key metrics; admissions to residential and care homes; effectiveness of reablement; delayed transfers of care; patient/service user experience; and a locally proposed metric.
  • There will no longer be a ‘payment for performance’ element of the fund. This was previously used to ensure that CCGs were given redirected funds to deal with emergency admissions if the fund had failed to reduce them. The £1 billion previously held back for payment for performance can now be used to commission any non-acute care, including social care.

Implementation

  • Implementation formally begins on 1 April 2016.
  • BCF will also be a key component of local areas’ multi-year strategic plans.

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