The £5.3bn Better Care Fund (formerly the Integration Transformation Fund) was announced by the Government in the June 2013 spending round, to ensure a transformation in integrated health and social care. The Better Care Fund (BCF) is one of the most ambitious ever programmes across the NHS and Local Government. It creates a local single pooled budget to incentivise the NHS and local government to work more closely together around people, placing their well-being as the focus of health and care services.
The BCF is a critical part of the NHS 2 year operational plans and the 5 year strategic plans as well as local government planning.
Below you will find the Guidance for the Operationalisation of the BCF in 2015-16. The document provides local partners to Better Care Fund plans – Clinical Commissioning Groups (CCGs), Local Authorities (LAs), and Health and Wellbeing Boards (HWBs) – with guidance on the operationalisation of these plans in 2015-16.
In particular it sets out:
Also included are a sample BCF Quarterly Report Template, and the BCF metrics analytical tool.
A national programme of support has been established to help areas overcome the barriers to the successful implementation of BCF in 15/16 that will run until the end of March. The focus is on practical implementation support to deliver better care for the local population.
The Better Care Fund is about improving the quality of health and social care available to the public. It is about moving away from a ‘sickness service’, and towards one that enables people to live independent and healthy lives in the community for as long as possible by joining up services around the individual person and their individual needs.
This can only be achieved by working differently – by working together across organisational boundaries to deliver the outcomes that matter to service users. Unfortunately, the way that our health and care services have evolved independently of each other over the last 60 years will make creating better, more coordinated care a difficult task. It will feel uncomfortable, risky and, at times, impossible. Working differently is always challenging, regardless of how much everyone shares the ambition to achieve the outcome.
The national Better Care Fund Support programme exists to help you to make the journey towards providing care in a joined-up and easily accessible way. One of the ways it is doing this is by providing access, across the country, to advice, support and ideas from peers, regional leaders and national experts who have trodden this path and who are there to help navigate the pitfalls and understand the depth of the challenges. The goals of the programme are to:
Between now and April 2015, the national Better Care Fund implementation support programme will provide support materials, tools and coaching to help areas overcome the barriers to the successful implementation of BCF plans in 15/16. The programme will provide localities with the advice, guidance and support that they need to feel confident that they can overcome fragmentation of health and social care services and achieve better coordination across the sector.
Key support products will include:
To get involved in the national Better Care Fund Support programme, or for more information, please contact: firstname.lastname@example.org
A series of ‘How to’ guides will focus on key topics where local areas have requested support, including:
The workshops will be driven by the topics that you are most interested in. The workshops will be facilitated by subject matter experts, will be highly interactive and will focus on developing practical plans to help you implement better care in your area. Following initial feedback the first workshop will focus on leadership.
The leadership workshops are aimed at BCF leads as well as leaders from health and social care and other interested individuals who are involved in the implementation of better care.
|East of England||KPMG office, Botanic House, 100 Hills Road, Cambridge||18th February||09:30 – 12:30||Paul Corrigan & David Reeson|
|West Midlands||KPMG office, One Snowhill, Snow Hill, Queensway, Birmingham||19th February||10:00 – 13:00||Hannah Miller & Gary Belfield|
|East Midlands||KPMG office, 31 Park Row, City Centre, Nottingham||20th February||10:00 – 13:00||Dr Stephen Richards & Gary Belfield|
|North East||KPMG office, Neville St, 1 The Embankment, Leeds||25th February||09:30 – 12:30||Dr Stephen Richards & Tom Keohane|
|North West||Memorial Hall at the Albert Square Chop House, Albert Square, Manchester||24th February||09:30 – 12:30||Gary Belfield & John Oldham|
|London||Royal National Hotel, Bedford Way, Russell Sq, London||26th February||09:30 – 12:30||Hannah Miller & Tom Keohane|
|South East||KPMG office, 1 Forest Gate, Brighton Road, Crawley||18th February||10:00 – 13:00||Gary Belfield & TBC|
|South||KPMG office, 100 Temple Street, Bristol||26th February||10:00 – 13:00||Dr Nick Goodwin & Gary Belfield|
To book a place, contact Better.Care@kpmg.co.uk.
To provide additional implementation support, we will be running virtual ‘drop-in clinics’ in February. These are one-on-one telephone calls with national experts for individual sites to discuss the particular challenges and issues they are facing in their local area. The experts will offer their wide range of experience and expertise and provide guidance and practical tips to address your priority needs.
The panel of experts will also be providing advice to other aspects of the programme, including input into the design of the implementation workshops and content of the ‘How-to’ guides.
The experts who will be providing support to the clinics and other elements of the programme are:
To book a one-to-one telephone clinic with an expert, email Better.Care@kpmg.co.uk.
Several areas will become Better Care Learning Partners. They will receive support and coaching, and the learning from these areas will be shared and disseminated through the Better Care Exchange (see below).
Between now and April 2015 the support programme will create, a single, accessible, place for sharing learning, information and good practice on delivering better, integrated health and social care and supporting the implementation of BCF plans. The Better Care Exchange will be created with the input of local authorities, NHS organisations and people who use services. This will ensure that all local areas have access to, and can make the most effective use of, existing good practice. Based on extensive co-production with stakeholders, the space will enable you to:
To ensure the Better Care Exchange is useful to you, please tell us what you want from the interactive space by completing a short survey that will take no more than ten minutes. There is a prize draw of £50 retail vouchers for one participant, and we are looking for responses before Friday 27 February 2015.
To submit your views please follow this link to the questionnaire.
A draft tool has been developed to enable you to benchmark your local area on metrics around Better Care. The Better Care Atlas includes the core BCF metrics as well as some additional metrics that relate to more effective use of resources. We are particularly keen to hear your thoughts on this draft tool, as we have plans to modify and develop it into a more user friendly platform in the Autumn. Please let us have any thoughts or comments via the BCF mailbox: email@example.com
Please note that the indicators in the Better Care Atlas are crude rates and have not been standardised for age, sex or other unavoidable causes of variation. When comparing Local Authorities, users should consider whether some of the difference may be influenced by these factors rather than variation in performance.
The statistical significance tool can be used by areas to aid in developing robust levels of ambition around their supporting BCF metrics. To note, for the ‘pay for performance’ metric (non-elective admissions) although there is an expectation that areas should meet a specific percent improvement, areas are able to set their own levels of ambition and take account of local considerations. Issues of statistical significance can therefore still be an important consideration for areas.
Please note that the information below is now out of date. However, as some of the material may still be useful, it is displayed below for reference.
Revised BCF plans were submitted on 19 September and subsequently went through a Nationally Consistent Assurance Review (NCAR) process. The outcome of the NCAR has categorised plans into one of four assurance categories: approved, approved with support, approved subject to conditions, or not approved.
All areas will have received their assurance outcome letter detailing the reasons they are in the assurance category and what the next steps are.
It should be noted that for plans that have been categorised as ‘approved’, formal approval by NHS England will come into force once the 15/16 mandate has been published with the requirements regarding the BCF.
To help local areas achieve the excellent plans to which they aspire, we have developed a robust programme of support. This slide pack, entitled “Making it Better – A guide to resources for improving Better Care Fund plans” provides more detail on what support will be available and how to go about accessing it. It also brings together a selection of resources that you can access immediately that will help you in developing a robust plan and roadmap for delivering integrated care. Over the coming weeks, as and when new resources are developed, we will add those into the “Making it Better” guide and highlight new content in the weekly BCF bulletin email from Andrew Ridley.
Update at 1 September – the Making it Better pack now includes links to the ‘How to’ Guide: The BCF Technical Toolkit. The ‘how to’ guide comprises an overview document and four chapters that provide advice and tips for completing the technical sections of the BCF planning templates. They were developed in response to questions and support requests from HWBBs developing their BCF submission, and are intended to complement the national and regional support offers including webinars and clinics.
Also included in the pack are links to some further support on risk sharing, following requests from local areas. This includes some additional background and suggestions for what to cover in the risk sharing elements of the template: this has been prepared by the BCF Task Force in consultation with NHS England, other health ALBs and professional bodies. As part of the wider support package, Bevan Brittan has also prepared a template S.75 agreement with an explanatory note. This will need to be adjusted to reflect the local situation, but gives a solid place to start.
Update at 8 September – Five fast-track areas submitted their BCF plans on 29 August and are going through the assurance process. The fast-track plans can be found here. As part of this work, case studies were developed to share with the wider system to help disseminate the learning. See here to view or download the case studies.
“The Making it Better guide” provides details on how to access targeted and bespoke support. It will be necessary to go via your relevant NHS England regional team, cc’ing in your Area Team and local government regional lead. The email addresses you need can be found in this document.
If you have any queries around the Better Care Fund Plan, please post a question in the comments section below. However, before posting a question below, please check the BCF Frequently Asked Questions document (updated 29 August 2014) which also includes questions that have been raised in the webinars held to date.
NHS England, alongside the Local Government Association (LGA), published a series of joint letters to the NHS and local government, with details of the BCF and its requirements.