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Government toughens up Better Care Fund scrutiny

Government toughens up Better Care Fund scrutiny

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The Government is creating a cross-department scrutiny team to supervise the Better Care Fund, NHS England (NHSE) has revealed.

Early assessment of plans for using the Better Care Fund suggested that they "lacked rigour and granularity" and could place CCGs at "significant financial risk", NHSE confirmed.

NHSE´s 2014-15 commissioning round update - released among board papers for today´s (July 3) board meeting - said it had initiated a tougher series of checks to mitigate the risks of planned savings not being realised through the £3.8 billion Better Care Fund initiatives.

The update, by Dame Barbara Hakin (pictured),  national director of commissioning operations at NHSE, said a cross-Government team is being created, reporting to a Ministerial Programme Board. A dedicated senior programme director will be appointed and a joint team across the Department for Communities and Local Government, the Department of Health and NHS England will also be created to oversee use of the fund. 

Arrangements for the performance element of the fund are also being strengthened to ensure that the costs of any activity which results from planned reductions not being realised can be covered, she said.

"We need to be sure this pooled budget will deliver better care for patients but also that it will reduce demand for unnecessary admissions to hospitals and care homes. If the appropriate reduction is not seen, both the NHS and local authorities will face financial challenge since this activity will still need to be funded.

"Because the Better Care Fund is not new money, much of it will have to be reinvested from existing NHS services. The Fund will support the development of social care and community health services which prevent unnecessary emergency admissions to hospital, reduce admissions to care homes, support discharge from hospital, and allow people to live more independently in the community. NHS commissioners will bear a significant financial risk if the local changes are not successful in reducing demand for hospital care, she said.

The update also summarised the current contracting position: as of 18 June 2014, 274 out of a total of 388 contracts nationally have been signed. 114 contracts are outstanding, with 88 where the contract activity and financial values have been agreed, and 26 where the contract activity and financial values have not been agreed. There are no contracts in arbitration.  

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