A chunk of the planned £3.8bn pooled health and social care fund will be held back from local commissioners unless they can demonstrate their investments have brought improvements for patients, HSJ has learned.
Chancellor George Osborne this week announced plans to more than treble the amount of NHS funding transferred to social care in 2015-16. The money will be allocated to local authorities, but plans for its use will need to be agreed with NHS commissioners.
HSJ understands ministers plan to appoint a “panel of peers” responsible for approving local commissioners’ requests to draw down the funding. The panel could include senior local government figures and experts in integrated care.
However, a portion of areas’ funding will not be paid up-front. It will be released only if clinical commissioning groups and councils can demonstrate their investments have resulted in improved outcomes, such as reductions in the proportion of patients with long-term conditions requiring emergency admissions to hospital.
An NHS England letter sent to CCGs this week said the £3.8bn fund would formally sit with local authorities, but plans for its use would need to be agreed by health and wellbeing boards, and signed off by council leaders and CCGs.
It added: “As part of the wider 2014-15 planning round, it is envisaged that plans would be developed this year, signed-off and assured over the winter and would be implemented from 2014-15.
“Plans and assurance would need to satisfy nationally prescribed conditions, including:
- Protection for social care services (rather than spending) with the definition determined locally;
- Seven day working in social care to support patients being discharged and prevent unnecessary admissions at weekends;
- Better data sharing between health and social care, based on the NHS number;
- Plans and targets for reducing accident and emergency attendances and emergency admissions;
- Risk sharing principles and contingency plans for if/when targets are not being met;
- Agreement on consequential impacts of changes in the acute sector.”
The letter also gave the full breakdown of where the £3.8bn fund would come from.
It will include: £1.9bn of “core CCG funding”, CCG reablement funding of £300m and carers’ break funding of £100m, £900m of NHS money already transferred to social care, and a further £200m to be added to that existing joint fund from 2014-15. The remaining £400m will be capital grants from the Department of Health and other government departments.
Care services minister Norman Lamb told HSJ that subjecting local proposals to central government checks would ensure there was “rigour” in the planning process.
“When you are doing something significant and putting money behind it, you want to make sure people go through a process of thinking through how best to use the money,” he said.
“There will be no prescription – but it’s important for them to be able to justify what they’re trying to do.
“This is a national health service – this is national money. We want to liberate local areas to demonstrate how [integrated care] can be done in their area.”