• Council calls for CCG to release £2.3m payment for performance element of fund
  • CCG withholding payment to council “in line with the national guidance”
  • Auditors found “no evidence” that funds provided for additional adult social care “has been used for this purpose”

FINANCE: Wiltshire Council could make a legal challenge against Wiltshire Clinical Commissioning Group following a dispute over better care fund payments.



The fund was introduced to encourage integration of health and social care, and closer working between the NHS and local government.

However, Wiltshire CCG has said it will not release £2.3m of its share of the fund to the council “in line with the national guidance”.

Part of the fund is a “payment for performance” element, which according to NHS England rules should only be released if the local authority has met the objectives of the better care fund.

In the CCG’s October board meeting minutes, reported by Marlborough News Online, it said one of the leadership team had attended a “difficult” meeting with the council to discuss the payment for performance element of the fund and the underspend.

The minutes added: “Currently the council are assuming 100 per cent of the underspend to their bottom line, which the CCG will not agree to. Also, Wiltshire Council does not recognise the [payment for performance] criteria, but this is essential for the CCG and must be secured”.

CCG chief financial officer Simon Truelove told the meeting he had held back the £2.3m performance payment from the council “in line with the national guidance” and stopped all better care fund payments “until the dispute has been resolved”.

In a separate incident, the CCG’s internal auditors reviewed the fund and found “no evidence that the £2.3m provided for additional adult social care has been used for this purpose”, the minutes said.

The CCG’s executive said a legal challenge by the council “is possible”.

HSJ asked to see a copy of the auditors’ report but a CCG spokeswoman said it was confidential while the group was in talks with the council.

She added: “Discussions are continuing with council colleagues and we are confident of a fair solution being agreed by both parties.”

A council spokeswoman said: “We continue to work very closely with the CCG and are confident of coming to an agreement over the better care fund.”

NHS England has not published better care fund figures beyond quarter one of 2015-16, but these figures show Wiltshire had fewer emergency admissions and delayed transfers of care than planned.

The recommended performance for payment amounts were made in quarter four of 2014-15 and quarter one this financial year, which suggests the disagreement between the council and CCG has arisen recently.

Both the CCG and the council have poor financial situations. The CCG aims to deliver a surplus of £700,000 this year but NHS England has told the board to produce a financial recovery plan “to restore the in-year position of a £5.5m surplus”, the minutes state.

The CCG highlighted the council’s “severe financial position and the political sensibilities around this” in its minutes.