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BCF escalation process threatens spending plans

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A total of 18 councils have been placed in a better care fund “escalation” process due to government concerns over their performance on reducing delayed transfers of care, LGC has learned.

Communities secretary Sajid Javid and health secretary Jeremy Hunt wrote a joint letter to 32 councils on 10 October, seen by the Health Service Journal. It warned them they were in the bottom quartile for delayed transfers of care per 10,000 of the population and in relation to reduction targets set in July.

Izzi Seccombe

Izzi Seccombe

Izzi Seccombe

Of these, LGC has learned 18 councils have also been placed in an escalation process and ordered to re-submit plans for spending their share of the £2bn for social care announced in the Budget.

A series of meetings have begun between these councils and officials from the Department of Health, NHS England and the Department of Communities & Local Government aimed at agreeing new spending plans.

LGC understands a small number of councils have already agreed revised plans, but the rest could still face having conditions placed on how their share of the improved better care fund is spent this year if agreement cannot be reached.

Local Government Association chair Lord Porter has told LGC that he was confident that control of funding would not be withdrawn from councils this year, but warned there could be “national direction” on how funding is spent next year if progress was judged to be inadequate.

The letter sent to the 32 councils states that the secretaries of state “favour options that place conditions on how you use a proportion of the additional 2018-19 [improved better care fund] to support DTOC performance”.

It adds: “None the less, we reserve the right to reduce the published allocation for a council should performance continue to fail to improve.”

Chair of the LGA’s community wellbeing board Izzi Seccombe told LGC the situation remained uncertain, adding that NHS-directed spending was an “expectation” and if implemented would be “effectively health spending our money”.

Staffordshire CC has been placed in the escalation process. At a cabinet meeting last week deputy leader Alan White (Con) said the council and heath organisations would present a “united front” and argue the case to maintain current spending plans at a meeting with DH, NHS England and DCLG officials the following day.

He told the meeting that the plans submitted a month after the BCF planning guidance was published in July had been approved by regional and national NHS England assurance panels but subsequently rejected by “an individual” in NHS England “who thinks we can do it better”.

Cllr White admitted a failure to resolve “points of difference” could have “serious consequences” for Staffordshire’s finances and wider service delivery. He warned that if “logic and common sense” does not prevail, some “very difficult decisions” would have to be made “corporately and within social care” to ensure the council is financially sustainable.


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