The NHS will expect health and wellbeing boards to prove they can save £1bn by joining up health and social care services next year – £300m more than currently anticipated, HSJ’s sister title Local Government Chronicle has discovered.

NHS England is understood to have identified the larger figure as financial scrutiny on local plans for the government’s better care fund project mounts.

These plans are required to set out how budgets will be pooled between councils and clinical commissioning groups.

LGC understands that an intensified “assurance programme” run by NHS England will focus on checking each plans’ forecasts of savings they claim could result from closer working, particularly by reducing demand for hospital services.

Current plans to spend the pooled budget, approved by health and wellbeing boards nationwide, predict savings totalling £700m in 2015-16.

However, there is uncertainty in both local government and the NHS that these savings will materialise.

The assurance process is expected to demand evidence to back up these forecasts and seek ways in which further savings could be made.

This tougher approach has attracted criticism from local government.

One senior council figure told LGC: “As a policy initiative the better care fund is the right thing to do, but it’s ridiculous to suggest it will save £1bn in its first year.

“When you change the way you deliver services you can often create more demand.

“And with demographics changing very quickly, it will be difficult to compare like with like over two years. So, even if services improve, it will be difficult to show that this fund has delivered savings.”

The source also warned that the lengthy assurance process could hinder the fund’s aim of transforming services.

“The issue is that, in areas where plans are good, people should be allowed to get on with them quickly,” they said. “Instead the whole process is stalling.”

NHS England’s focus on using the better care fund to make savings sets it apart from the LGA, which this week demanded the government put additional funding into the programme in 2015-16.

The LGA’s call followed a blog post by its chief executive Carolyn Downs last month, in which she warned: “Given the £2bn shift required from the NHS, a fund of this level would ease transformation and protect the public from the short-term disruption that may arise in hospital services.”





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