Oxfordshire commissioners failed to submit a realistic better care fund plan in part because they were distracted by work on other local integration initiatives, they have admitted.

The county’s better care fund plan was one of just five across England which was not approved last month after NHS England’s assurance process for the programme.

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Oxfordshire’s better care fund plan was one of five not approved by NHS England

A joint statement by Oxfordshire Clinical Commissioning Group and the county council cited a range of reasons why their proposal, which was submitted in September, had been neither realistic nor comprehensive.

“These included our new focus on commissioning health and social care services via outcomes based commissioning, the timescale for which crossed over with those for the submission of initial better care fund proposals”.

The council and the CCG said another reason why the plan did not meet national requirements was “the national expectation that emergency admissions to hospital should reduce, when hospital admissions are rising locally and nationally.”

The statement concluded: “The clinical commissioning group and the county council are working hard with Oxford University Hospitals Trust and Oxford Health Foundation Trust to address the challenges and issues regarding the implementation of the better care fund principles.”

Oxfordshire CCG has spent the past year redesigning its proposals to introduce integrated outcomes based contracts for adult mental health and older people’s services.

The ambitious scheme attracted controversy a year ago when both local trusts publicly expressed serious concerns over its potential impact.

The other four better care plans not approved were: Essex, Lancashire, Hillingdon and Northamptonshire (see box, below).

Northamptonshire plans rejected

HSJ understands Northamptonshire’s better care fund plan was rejected because the county’s health and wellbeing board did not sign off the proposal, after NHS and council members failed to agree on how parts of the fund should be used.

While there was broad agreement on local integration plans, there was a disagreement over how much NHS money should be used to maintain existing social care services. The council demanded millions more than Nene and Corby CCGs was willing to contribute.

Although relationships between the CCGs and council are understood to be relatively good, the disagreement was caused by both sides having acutely tight financial circumstances.

Northamptonshire is one of 11 designated “challenged” health economies, while the county council is also regarded one of the most financially stretched in the country.