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https://jonrouse.blog.gov.uk/2013/12/20/the-better-care-fund-a-spur-to-integration-and-innovation/

The Better Care Fund: a spur to integration and innovation

For me, one of the defining moments of 2013 was the announcement last June of the £3.8 billion pooled fund intended to promote and galvanise joint working between health, care and support services to create truly integrated care at a local level.

Now known as the Better Care Fund, it represents the biggest opportunity yet for local services to come together to improve the health and lives of people in their communities.

These pooled budgets come into full force in 2015, but I’m delighted to see collaboration already underway across the country, led by the 14 integration pioneers announced last month by our Minister for Care and Support, Norman Lamb.

I’m delighted too that further support has been reaffirmed today in this letter to sector colleagues from Norman Lamb and Brandon Lewis, the lead ministers for the fund. Together, they reference the extra £200 million available for local areas through the NHS transfer to social care next year. This additional funding will support the transition to better integrated care. The letter also refers to the guidance now available to help CCGs, local authorities and their partners understand and meet the conditions and other criteria for the fund.

I also echo the ministers’ call to local authorities, clinical commissioning groups (CCGs) and care and support services to begin intensive planning now, if they haven’t already done so. Draft plans have to be submitted by mid-February. Like the 14 pioneer areas already announced, I’m looking forward to seeing the innovation, enthusiasm and creativity I know is out there expressed in ambitious programmes for real change. It’s also worth visiting the LGA website as there are some really useful tools and resources there, including forthcoming webinars on particular hot topics. We are also running a number of regional events over the next two months.

What we all want to see is a seamless pathway of care that delivers the best possible health outcomes for people. In a previous blog I set out some of the essential characteristics of successful integration. But there is no blueprint. It will mean different things in different places. Some of the key things we want to see are:

  • Professionals sharing information about the individuals they care for, working as a team to find the best solutions to support people’s lives
  • Health and care planning coming together to increase the range and provision of seven day services so people receive the help they need, when they need it. This includes getting them home as quickly as possible following hospital stays
  • More preventive action and proactive support to keep people well, leading to greater independence for longer, and a reduction in emergency admissions
  • Properly assessed and managed admissions to residential care, with assessments taking place at home rather than in hospital, wherever possible
  • Really thinking through the consequences for the acute sector and how these can be properly planned and managed based on full risk assessment
  • Making sure we think about how other parties can contribute to new models, including, crucially, the role of carers and other providers, such as social landlords.

Health and Wellbeing Boards have a crucial role at local level to help make better integration of health and care services a reality. They will ensure that all key partners have contributed to - and are in agreement with - the plans.

From Barnsley to Kent, Torbay to Greenwich, we’ve already seen the fruits of smarter integration through earlier, joined-up interventions, but I know there is so much more we can achieve, both locally and nationally.

The Better Care Fund is a fantastic opportunity to do more, better, faster. This is challenging and exciting work and I look forward to seeing even more innovative solutions developed as we head towards 2015.

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6 comments

  1. Comment by Chris Sterry posted on

    On paper this would, indeed, appear to a positive change.

    On some issues there should be more intergration of health and social care and support services. This would or should lead to cost savings and a more joined up working practice and minimise the need for duplication. However, certainly in health and more than likely in social care, there are areas of specialisation where an indepth knowledge is an important factor. One of the major drawbacks to greater joint working and intergration is the spreading of these specialisations and if spread too far, for too long, could mean that the speciasation is reduced to a level that is no longer sustainable and the specialisation is lost.

    This would be a great loss to those in the communities who rely on these specialisations for their continuation of their life on a reasonable level.

  2. Comment by Julie Quinn posted on

    SSAFA is a charity that has provided integrated Health and Social Care for the military community in the UK and overseas for over 50 years. We are happy to share our experience in this area.

  3. Comment by Debt Relief posted on

    I think we all want the best possible health outcomes for people. How do people receive the help they need, when they need it?

  4. Comment by simonfj posted on

    John,

    Could I just focus on one part of the "essential characteristics for integration, and ask for a reply, either on this blog, or any other online forum that people from the 14 integration pioneers may be sharing already.

    The primary point here is "sharing data". The one fundamental part of any "joined up services" is that every patient requires one account to which their records are attached, and shared as necessary. All your BCF teams will agree with this. This is, as the GDS people would say, a "design principle".

    Now the GDS teams are designing services for "users". i.e. a citizen is treated as a different user by each departmental service. This is a completely different design philosophy. So we have this tug between the National services, which are designed to enhance a citizen's privacy (from big brother), while at a Local level, no (seamless) coordination can happen unless a citizen's individual departmental accounts are combined.

    Is there any way we can have this impasse addressed?

    We can see, from a network design perspective, the two design philosophies are coming together at this juncture. http://my.civilservice.gov.uk/job-share/ where employed civil servants have the opportunity to collaborate with their extra-departmental peers, if the interpretation of "civil service" was treated more liberally.

    I would appreciate a reply here, so i can point people at it. Thanks.

  5. Comment by Does Creatine Work posted on

    The idea of affordable health care or at least a basic level of care for all members of a society is a wonderful "idea" in theory but how does one go about funding without making the tax paying base responsible for 45% of it? How do you level price caps on procedures and still attract the best, most qualified people? The best people do not take low paying, but stable government jobs? I've been watching the United States struggle with a national healthcare problem for decades. They have many more people than other countries and many more immigrants. So the issue is always, who is going to fund this? What happens when more people who cannot pay or afford to pay, show up and require care? What happens when those who can pay, decide they've had enough? I've never seen any good solution yet. How do people receive the help they need without being turned away?

  6. Comment by Walnut Creek Chiropractor posted on

    I'd like to see this type of situation occur worldwide where the sharing of information would really solve some major problems. The roadblock that I see is that information has always been a commodity. Those with it are more powerful than those without. Minus the goodwill, it will be very tough to get this done. However, when it comes to health and human services, the connection of diverse systems that could potentially save lives and reduce costs is a noble one. I'm glad to see that the idea of an interconnected system hasn't been given up and people are willing to fund what is right. I also would like to know how people will not be turned away but receive top quality health care? Or is that just a utopian dream?