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NHS leaders urge caution on better care fund

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The £3.8bn better care fund should not be extended until the impact of its first full year of operation has been properly evaluated, NHS leaders have warned.


The Five Year Forward View, which sets out the collective view of national NHS organisations, strongly cautions politicians against moving quickly to transfer more NHS money into the pooled fund for joint health and local authority commissioning.

Under the better care fund at least £1.9bn of money currently spent by clinical commissioning groups will be transferred to the pooled fund in 2015-16.

The Forward View states that “a proper evaluation of the results of the 2015-16 BCF is needed before any national decision is made to expand the fund further”.

The document is also ambivalent about the scope for health and wellbeing boards to assume greater leadership of health and social care systems, or for widespread development of “full joint management of social and health care commissioning”.

It states that national NHS bodies will work with “ambitious local areas to define and champion a limited number of models of joint commissioning between the NHS and local government”.

These will include joined up personal budgets to run across NHS and social care – as previously announced by NHS England chief executive Simon Stevens.

It adds that they will also include “better care fund-style pooling budgets for specific services where appropriate, and under specific circumstances possible full joint management of social and health care commissioning, perhaps under the leadership of health and wellbeing boards”.

HSJ understands that where health and wellbeing boards are able to prove themselves effective system managers they will be backed. However, they are not central to NHS England’s vision for how the NHS will be led in the medium term.


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