The Department of Health and the Cabinet Office will today meet with health and local government representatives to draw up a tougher set of tests for the better care fund.
The stricter assurance programme expected to come out of a what will be a series of meetings could allow for direct Whitehall intervention in areas where plans are deemed not to have been properly developed.
Proposals due for discussion, include new demands for detailed risk assessments of each better care fund plan and a right to refuse those without convincing evidence bases which are underpinned by financial and performance data.
A government spokeswoman said it had requested early drafts of the plans so it had “time to make sure they will deliver better care and reduce demand on services”.
“Every area is currently finalising its plans and we are working with the NHS, Local Government Association and local Health and Wellbeing Boards to support this last stage of the process before ministers grant funding,” she added.
The DH will expect each plan to demonstrate by how much they expect to cut emergency activity as a result of the health and social care integration. The department is understood not to recognise the 15 per cent reduction in emergency activity which NHS England said it expected from better care fund plans in draft planning guidance last year.
The stricter approach to assurance comes in response to Whitehall and broader concerns in the health sector that too many of the final plans submitted by health and wellbeing boards last month did not include convincing data about how social care spends could cut hospital activity
Sources close to the discussions told HSJ that the new assurance process would resemble the clinical commissioning group authorisation system.
Under this regime, plans would be signed off in several tranches, based on how robust they are judged to be.
The most impressive will go first, followed over the next couple of months by those which are broadly sound but require more work, such as stronger evidence base.
The DH is also considering a programme of intervention for health and wellbeing boards whose plans are judged not to be sufficiently robust.
This could involve the DH, Local Government Association or NHS England working directly with a health and wellbeing board to develop their plan, or matching their boards with another, which is considered to demonstrate best practice in the relevant area.
The last plans are due to be signed off in September.
As previously reported by HSJ, health and wellbeing boards will also be assessed on how well they have involved local health providers in planning the better care fund.
There is no suggestion yet that the fund will not be implemented in full from the beginning of 2015-16.