Finance experts have joined the calls for ministers to find funding to pump-prime the integration of NHS and social care services.
A report by the Chartered Institute for Public Finance and Accountancy, shared exclusively with HSJ, said that although NHS and local government finance professionals were keen for integration to happen, further upfront investment from the government was necessary.
CIPFA has also criticised the government’s flagship integration policy, the better care fund, and urged ministers to recognise that combining two financially challenged systems “will not in itself increase resources available”.
“All the indications are that additional funding or changes to the regime for charging will also be needed,” the report says.
CIPFA’s head of health and integration Jane Payling, a former finance director at Papworth Hospital Foundation Trust, told HSJ money was needed to create “head space” for senior leaders to establish new ways of working. “It takes time to change the way of doing things. The old will need phasing out. There will be a transitional period, and the double running will have to be picked up.”
CIPFA has not said how much upfront investment is needed, but Ms Payling pointed to the recent call from the King’s Fund and Health Foundation for an annual transformation fund of at least £1.5bn throughout the current Parliament.
On the BCF, the CIPFA report said “the lack of new money is a problem” while “the mechanism doesn’t balance incentives across system, and more rapid results are expected than are likely”.
Successful integration will require joint planning over several years, “rather than the one year emphasis of the BCF”, the report added.
It also compared the policy’s “prescriptive approach” unfavourably with the more permissive regional devolution programmes.
CIPFA chief executive Rob Whiteman added: “The government needs to act quickly and recognise that integration should not be an end in itself and it should not become weighed down by bureaucratic rules and targets.
“Instead, the government must accept that there will be significant upfront transitional costs and encourage local services to work together, build community capacity, plan for the medium term and focus on prevention.”
The BCF remains the government’s main policy for integrating health and social care. It featured prominently in the Conservative Party’s election manifesto, and was credited by health secretary Jeremy Hunt at this month’s Conservative conference with integrated care “finally becoming a reality”.
A joint letter from health and local government ministers last week confirmed the BCF would continue in 2016-17, but did not say whether it would be extended.