The better care fund should be scrapped beyond 2016-17. The longer it lingers, the more the policy will divert money and attention away from efforts to fuse health and social care
NHS England is right to call for the better care fund to be frozen rather than expanded next year.
Beyond 2016-17, it should be scrapped.
The fund’s big contribution was to make the entire health and care system the business of both NHS and council commissioners, everywhere in the country. Its legacy is to make joint commissioning of health and social care the norm.
‘A uniform commissioning system of CCGs and health and wellbeing boards now looks a bit quaint’
We no longer need it for this to continue. The policy has a problem with credibility. It is associated with double counting by the Treasury and the production of vast numbers of spreadsheets and business cases in the name of “assurance”.
It is likely the initiative will not demonstrably reduce pressure or save money in the acute sector in the short term, and will therefore be judged a failure.
More fundamentally, a Whitehall order to pool a portion of NHS and council budgets is now an outdated approach.
A uniform commissioning system of CCGs and health and wellbeing boards now looks a bit quaint. Bolder solutions are on the way: regional devolution; capitated budgets allocated directly to providers; and integrated personal commissioning.
These will make the fund redundant. The danger is the longer it lingers, the more the policy will divert money and attention away from efforts to more profoundly fuse health and social care.