Changes to Better Care Fund undermining localism: chief executives

Changes announced by health secretary Jeremy Hunt have undermined the localist base of the Better Care Fund, council chief executives have warned.

The £3.8bn fund will from next April allow health and wellbeing boards to set their own performance targets but now within a guideline reduction in unplanned hospital admissions of at least 3.5%, equivalent to some 185,500 fewer admissions a year.

Local plans now also face a further review by both DCLG permanent secretary Sir Bob Kerslake and NHS chief executive Simon Stevens “to ensure they are ambitious enough to achieve improvements in care and that every area is on track to begin in April next year”, the Department of Health said.

It also said that a new Better Care Fund programme director post would be created with an expanded team, working across Whitehall, local government and the NHS.

But Graeme McDonald, director of the Society of Local Authority Chief Executives and Senior Managers, said the fund was intended as a crucial step toward a sustainable, locally integrated health and care system.

He said the “crude national target” for reducing hospital admissions “undermines the original, localist ambitions of the fund.

“By setting up a new national programme office, requiring places to submit another round of detailed plans and setting a crude national target, the Government has created unnecessary layers of bureaucracy,” he said.

“This will undermine the ability of local areas to jointly develop plans that make the most sense for their place.”

Mr McDonald said the changes would lead to substantially reduced investment in the community and social care needed to keep people healthy and independent.

Launching the changes, Mr Hunt said: “Local authorities and the NHS are making excellent progress in developing plans that will give patients better, joined up care and allow hospitals to focus on treating the people who really need to be there. The plans are packed full of ideas and show that strong partnerships are being forged with different teams like never before.”