The Better Care Fund was implemented based on “optimism rather than evidence” and will only deliver a third of the expected savings, official government auditors have found.
A highly critical report released by the National Audit Office (NAO) today claims that the quality of early preparation and planning did not match the scale of ambition.
The Better Care Fund was implemented based on “optimism rather than evidence” and will only deliver a third of the expected savings, official government auditors have found.
A highly critical report released by the National Audit Office (NAO) today claims that the quality of early preparation and planning did not match the scale of ambition.
The NAO has called for more effective support to be given to clinical commissioning groups and health and wellbeing boards. Joint working between health bodies and local authorities must improve, the report states.
The Department of Health expected to save £1 billion, but savings are only likely to reach £314 million, the NAO claims. A total of £5.3 billion of NHS and local authority funding will be pooled when the fund runs from April 2015.
The policies were developed by the Department of Health and Department for Local Communities and Local Government, while NHS England and the Local Government Association was responsible for the delivery and implementation of the Fund.
As the BCF was developed by local areas, until recently there was no central programme team or programme director. The NAO criticised the Department of Health for the lack of risk management and failure to check local planning capacity, capability or where local areas would need support.
Officials responsible for setting up the Better Care Fund will now be subject to questioning from the Public Accounts Committee.
Chair of the committee, Margaret Hodge, said: “Planning for the Better Care Fund has been a shambles. The Fund is a complex and challenging initiative that clearly requires strong leadership and effective cross government working, both of which have been lacking.
“It is hard to believe that until recently there was no central management team or programme director. Such incompetence from Departments is unacceptable at a time when the number of people most likely to need care is rising, and overall funding is falling.”
Amyas Morse, head of the National Audit Office said: “The Better Care Fund is an innovative idea but the quality of early preparation and planning did not match the scale of the ambition. The £1 billion financial savings assumption was ignored, the early programme management was inadequate, and the changes to the programme design undermined the timely delivery of local plans and local government's confidence in the Fund's value.Ministers were right to pause and redesign the scheme in April this year when they realised it would not meet their expectations.
“The Fund still contains bold assumptions about the financial savings expected in 2015/16 from reductions in emergency admissions. To offer value for money, the Departments need to ensure more effective support to local areas, better joint working between health bodies and local government, and improved evidence on effectiveness.”
