Better care fund plans must share risk between hospitals and commissioners to prevent the acute sector losing out if they fail to deliver, health secretary Jeremy Hunt has revealed.
In a speech to the NHS Confederation Conference in Liverpool, Mr Hunt described the project as a crucial means of making the NHS more sustainable, alongside the emphasis of patient safety and NHS England’s plan to give CCGs a greater role in commissioning primary care.
Mr Hunt said hospitals should not lose out under the better care fund project.
“Any out of hospital organisation that is benefiting from extra resources as a result of the better care fund, on the basis that they are going to reduce emergency admissions into hospital, must share some of the risk if what they are doing doesn’t in fact reduce emergency admissions.
“By making sure we have a proper risk sharing profile in all the better care fund plans, what we will do is make sure incentives are properly aligned.”
He hailed work by NHS England chief executive Simon Stevens to allow CCGs to commission primary care directly, which he said could be “the first step in turning CCGs into accountable care organisations”.
This could also present opportunities to use capitation rather than activity based budgets to create a “revolution in out of hospital care”, he said.
Mr Hunt admitted the NHS was “running hot” dealing with thousands more referrals and operations, but he urged leaders to pursue the patient safety agenda to achieve sustainability.
Following the Francis report in February 2013, Mr Hunt said the NHS had done a “rather wonderful thing” in recognising the elements of poor care seen at Mid Staffordshire and “stamping them out”.
He warned the conference that “there can be no turning back the clock on Francis”, warning that the system would “run even hotter” in the future.
“Unsafe care is one of the most expensive things you can possibly do,” he added. “It is probably the single biggest waste of resources in the NHS.”
The cost of adverse events drained NHS budgets of £800m a year, the minister said.
He repeated the message that a better culture in the NHS was key to creating a safer service, arguing: “We have to be much bolder and braver in our use of data.”
Answering questions from the audience, Mr Hunt said he would like to see the mental heath sector develop waiting times to tackle the question of funding under the parity of esteem agenda.
Named accountable clinicians should be responsible for patients with severe mental health needs, he added.
Asked about NHS funding, Mr Hunt said there was a political consensus over funding up to the end of 2015-16, adding: “We will have to have a debate beyond that time about how we fund the increasing pressures from an ageing population.
“But I will say this: it’s much easier to make the argument for extra funding if we really have been innovative and done everything we can to eliminate waste.”