New deal to support integration of health and social care

Four national conditions are attached to the £2,077 billion improved funding of the government’s 2021-2022 Better Care Fund *policy framework, to drive health and social care integration.

They are: 1. A jointly agreed plan between local health and social care commissioners, signed off by the Health and Wellbeing Board (HWB).

“BCF plans should set out a joined-up approach to integrated, person-centred services across local health, care, housing and wider public services. They should include arrangements for joint commissioning, and an agreed approach for embedding the current discharge policy in relation to how BCF will support this.”

2. NHS contribution to adult social care to be maintained in line with the uplift to CCG minimum contribution.

“The 2020 spending round confirmed the CCG contribution to the BCF will rise in actual terms by 5.3% to £4,263 billion. Minimum contributions to social care will also increase by 5.3%.”

3. Invest in NHS-commissioned out-of-hospital services.

“BCF narrative plans should set out the approach to delivering this aim locally, and how health and local authority plans will work to deliver it.”

4. A plan for improving outcomes for people being discharged from hospital.

“This national condition requires areas to agree a joint plan to deliver health and social care services that support improvement in outcomes for people being discharged from hospital, including the implementation of the hospital discharge policy, and continued implementation of the High Impact Change Model for Managing Transfers of Care.”

Metrics

Areas will have flexibility in how the fund is spent over health, care and housing schemes or services, but need to agree ambitions on how spending will improve performance against the following BCF 2021 to 2022 metrics:

• Discharge Indicator Set
• avoidable admissions to hospital
• admissions to residential and care homes
• effectiveness of reablement.

Systems will be asked to set expectations for reductions in avoidable admissions (classified as the rate of emergency admissions for ambulatory sensitive conditions) and for metrics related to discharge from quarter 3.

The document says:

“The response to the Covid-19 pandemic has demonstrated how joint approaches between health, social care and the wider public sector, can help to improve the wellbeing of people even in the most difficult circumstances.

“The government is keen to ensure those positive changes are built upon while also recognising that areas are at different stages of their journey towards better joint working.”

It goes on to recognise that “upcoming changes” such as proposals in the Health and Care Bill, will “likely impact longer-term system thinking and planning.”

And it acknowledges: “Future iterations of the BCF may require local areas to consider their response to upcoming changes as part of their strategic planning.”

*FCC and the National Care Forum have submitted a joint response to the government’s draft National Data Strategy.