The Better Care Fund is a pooled fund that will be issued to CCGs and Local Councils. It is money which must be spent on implementing integrated health and social care and the tagline is that it will provide an opportunity to transform local services whilst providing people with better integrated care and support.

I believe this can only be achieved if H&W Boards are willing to rise to the challenge and use the Better Care Fund as a lever for their authority, and a motivation for action.

Along with my colleague in local government I have been researching how H&W Boards engage with their stakeholders. We have spoken to different stakeholders and board members and two main issues have been repeatedly expressed:

  • H&W Boards have no role to assert  authority over their health and social care stakeholders.
  • H&W Boards have no remit to motivate action across their health and social care stakeholders.

How will the Better Care Fund change this?

In order to receive the fund, health and social care stakeholders must compose a Better Care Fund plan. This plan will need to be signed off and delivered by the H&W Boards. If a signed off plan is not produced, no funding will be issued to the area. If the H&W Board are unsatisfied, they can escalate this to NHS England, and it is the LGA who will make the final decision of whether the fund will be issued.

This position of authority over the Better Care Fund plan provides H&W Boards with the leverage  to influence health and social care stakeholders, and lead integrated working to produce a high quality plan.

Furthermore, once the care plan has been delivered, these organisations must work together to meet national conditions and set criteria in order to receive the money the following year.  If these are not met to NHS England and the LGA’s satisfaction, no funding will be issued to the area. These metrics will provide H&W Boards with the motivation to work together with health and social care stakeholders to implement the  Better Care Fund plan.

The Better Care Fund will therefore mean that integrated working under H&W Boards is no longer a nicety but a necessity, no longer ideological, but imperative. It is a chance for H&W Boards to take authority and action truly integrated health and social care across their borough.

Annette Jack is a Consultant in the BDO Healthcare Team.

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