Bold councils and CCGs are using the better care fund has a launch pad for grand integrated care projects, and their ambition should be welcomed

For well over a decade, anyone wanting to discuss meaningful integration of health and social care in the NHS had one strong example to cite – Torbay. But, at last, it appears as if the Devon resort is no longer going to have to plough that furrow alone.

As HSJ observed last month, the better care fund is wracked with problems stemming from the fiscal sleight of hand that meant the cash was effectively double counted in NHS and local government finances.

However, the conversations the fund has engendered between the NHS and local government have generated some very significant conclusions about the future shape of services. Sheffield has declared it plans to create a £278m joint health and social care budget next year and that its “ultimate aim” is to have a single pot for all spending in the area.

‘Partners appear to be using the better care fund as a launch pad for something grander’

Some of the country’s other cities and major towns are also going further than required under the fund: Sunderland, Salford and West London are all placing sizeable funds into a single budget. Plans in Birmingham may dwarf all others.

Applaud the ambition

Nor is it an entirely urban phenomenon: Dorset, Hertfordshire and Lincolnshire, for example, appear to be using the better care fund as a launch pad for something grander.

‘The last few months have seen a regular drip feed of bad news about NHS finances’

However, pooling funds will mean nothing if it is not used to drive service change. In Sheffield the focus is on the development of intermediate care. Notably, the partners have already begun to think about how the aims of the joined up service might be expressed in contractual terms, while health and social care providers are being encouraged to get comfortable about working together. Equally significantly, may not need to hold a competitive tender to establish the new arrangements.

Before Sheffield’s announcement the biggest joint budget was Hertfordshire’s £240m. The county’s plan speaks of ensuring service users are given “a lead or accountable professional” who would help them “navigate our health and social care system” and also promises services will “responsibly share data and information on patients” across organisational boundaries.

The last few months have seen a regular drip feed of bad news about NHS finances and credible warnings about the sustainability of many social care services. The plans being put together in, for example, Sheffield and Hertfordshire will perhaps fall short of their lofty goals – but in the context within which they have been produced .we should welcome their ambition