Ministers: Involve providers in 'better care fund' talks

The two ministers’ letter, sent yesterday, emphasised the “importance of sustained involvement and engagement of the leadership of the acute sector and primary care” (see letter attached).

It follows concern from some providers they are being excluded from discussions about use of the fund, which will include money pooled by the NHS and local authorities. In 2015-16 it will be worth £3.8bn nationally, with around £2bn funded by the NHS, and is designed to be ring-fenced for out of hospital services. Officials have warned it could mean a “cliff edge” funding cut for hospitals.

The letter, also sent to all local authority leaders and directors of adult social services, states: “It is essential that the acute sector and primary care are active partners in developing local plans, working with you to agree how you will invest in joined up services that help people stay at home for longer, get them home from hospital more quickly and prevent them from getting ill in the first place.

“We expect that plans will demonstrate that this engagement has taken place and provide an assessment of the likely impact of plans on reducing pressure on acute partners and achieving the best possible outcomes for local people.”

NHS England and the Department of Health have both previously expressed concerns about HWBs’ relationships with providers.

Speaking at an NHS Confederation event in London earlier this month NHS England director of partnerships Ivan Ellul said: “The level of provider engagement is still low and I think this reinforces a message we’ve been hearing from providers about health and wellbeing boards not really reaching out to them to take part in discussions. If we’re going to transform services over the next few years, that’s a real gap.”

Department of Health director general of social care and local government Jon Rouse, speaking at the same event, said lack of provider engagement was the “one significant disappointment” of the first year of HWBs.

He said the groups could “become… separate from the realities of how the system is working and adapting on the ground”.

Foundation Trust Network chief executive Chris Hopson told HSJ a “small minority [of providers and HWBs] really have made this work”, but that there were a “very significant number of places where providers feel the engagement has been less than [what] they believe is necessary to manage the risk”.

He said there was a “risk the CCG will take its money away on the basis that the demand is going to be met elsewhere, but if the new delivery structure doesn’t work and doesn’t take that demand away, it’s still going to walk in through the accident and emergency department”.