Using Funding Transfer Agreements to help people move out of hospital in Midlands and East

Case study summary

Funding Transfer Agreements (FTAs) are helping people with a learning disability, autism or both to move out of hospital. After a successful pilot in the Midlands and East region, they are now in use across the whole of England.


The FTA means that when a person moves out of hospital and their bed is decommissioned behind them, their funding moves with them to their Transforming Care Partnership (TCP). This allows the TCP to pay for that person to be supported to live in their community.

Many hospital places for people with a learning disability, autism or both are paid for at a national level by specialised commissioning, which reflects their specialised nature. TCPs can now apply for an FTA which moves the money to their local budget.

TCPs fill out an application form which must show that the person moving from hospital has a home and provider ready, with clear costs and which meets the principles set out in Building the Right Support.

The applications are reviewed by the region’s new Specialised Commissioning Funding Transfer Panel. As it meets every two weeks, the TCP knows very quickly if they will receive funding and can start to make the move happen.

Moving the money

Since March 2017 33 FTAs have been issued, moving £4.1m inpatient costs into £3.5m of community funding. The costs to help people live in the community have been cheaper than inpatient costs – resulting in a saving of £0.6m so far.

24 of the 33 people covered by FTAs moved into the community and nine into from hospital into ‘step-down’ locked rehabilitation, which the region approved where they showed a clear path to discharge.

The process is helping to reduce the number of inpatient beds forever. The team have been working with local providers and are about to issue a contract variation to stop funding for 24 beds.

The process is now being rolled-out nationally and TCPs are encouraged to apply for FTAs.

George had been in hospital for almost six years before he was discharged to a supported living provider. He is being supported by his provider who are using positive risk management and helping George to develop networks of support.

George’s discharge plan, risk management plan and pathway of care were reviewed and approved through the CCG and local authority assurance processes. The Intensive Support Team are overseeing and reviewing this regularly with a view to decreasing the staff ratio and costs.

George’s community package, costing £141,652, was secured via the FTA process. This is less than the cost of his inpatient bed (£168,400), and the remaining funds have been put into a virtual pool to fund both other packages that may cost more than the bed and new community services.

The transfer of funding from specialised commissioning has provided some assurance and confidence to TCPs who are facing significant financial challenges.


Jenny Butler:

Yasmin Surti: