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Exclusive: CCGs see Better Care Fund as ‘catalyst for change’

Exclusive: CCGs see Better Care Fund as ‘catalyst for change’

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Commissioning leaders have refuted claims from NHS England’s medical director that the Better Care Fund (BCF) would be used for “filling in potholes”. 

If it is used correctly, the BCF could be a “catalyst” for dramatic improvements to the healthcare sector, commissioning leads have told The Commissioning Review. 

The BCF, formerly known as the Integration Transformation Fund, was announced by NHS England in June 2013 with the aim of “transforming” integrated health and social care. 

A single, pooled budget of £3.8 billion was taken from clinical commissioning group (CCG) and local government funding to support health and social care services to work more closely together.

Earlier in January, Sir Bruce Keogh told the Health Select Committee there was “great scepticism” that the BCF would manage to reduce demand on A&E services. 

He said: “There is a fear that the labels will be taken off the money and that it will be used for filling in potholes.” 

Chair of the Health Committee, MP Stephen Dorrell said it was time to forget “jealousies” between local authorities and CCGs, and think about the fund from the point of view of individuals who need good care. 

“It’s about engaging communities in decisions that affect the way care is delivered. I don’t really care if it’s called healthcare or social care,” he said. 

“What I care about is, if we look at our system and ask ourselves where we fall down too often, it’s often where we have to deliver joined-up care between the three bureaucracies we’ve inherited – primary, community and social care.” 

He said that the Better Care Fund could be a way to “break down” those boundaries, and Charles Alessi, chairman of the National Association of Primary Care agreed. 

Alessi said he “doesn’t care” where the money goes if it is spent on improving outcomes. “If we start worrying about where [the money] goes instead of focusing on the results, we will be in as much trouble as we have over the past 20 years! We need to do something different,” he said. 

The latest figures from the King’s Fund show one in eight clinical commissioning groups are headed for a deficit. Social care’s prospects are much worse, with more than a third (36%) of directors of adult social services expecting to be in deficit by the end of the year. 

Jonathan Fagge, chief executive officer of Norwich CCG acknowledged that there could be some “real financial challenges” from working more closely with the social care sector. 

He said: “There will have to be some difficult conversations about the extent to which [the money] is invested in health or some of the challenges around social care, but I do hope that a year from now, many CCGs will be reporting on how they used the catalyst of the Better Care Fund to bring the health and social care systems together.” 

Despite the financial difficulties, leaders speaking to The Commissioning Review feel that if CCGs embrace the scheme healthcare will be improved locally. 

Dr Steve Kell, chairman of Bassetlaw CCG and co-chair of the NHS Clinical Commissioners leadership group said: “There’s a significant risk that we’ll just prop up what is already there and we’ll end up losing money from the NHS. 

“So it’s really essential that CCGs are strong in leading that work and making sure that we do benefit and that clinical outcomes are improved.” 

Deputy clinical chair of Kingston CCG, Phil Moore, said that the BCF is a chance to “transform” the sector. 

He said: “If we simply ‘survive’ the BCF we will have failed. If we can seize it, if we can take this as an opportunity to do things so differently that the face of healthcare locally is not going to look the same again, I think we will have succeeded in our fundamental task.” 

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