latest health care news


Former £1bn BCF ‘performance fund’ replaced with delayed transfer plans

The government has decided to scrap the “time-consuming and bureaucratic” performance element of the Better Care Fund (BCF), instead replacing it with the requirement that local areas fund NHS-commissioned out-of-hospital services and develop an action plan to manage high levels of delayed transfers of care.

In a policy paper published last week, the Department of Health revealed it would remove the £1bn conditional ‘payment for performance’ framework it had originally tied to the BCF – which could ultimately allow the government to refuse cash to areas that fail to cut emergency admissions.

While developing the framework, the department said it came across strong feedback from local areas of “the need to reduce the burden and bureaucracy” in operating the fund, the government’s new £5.3bn flagship scheme to promote health and care integration.

Last month, healthcare industry leaders from the Chartered Institute of Public Finance and Accountability and the Healthcare Financial Management Association said more needed to be done to simplify the “unwieldy” Fund process and its unrealistic expectations.

In an effort to streamline and simplify the planning and assurance elements of the payment for performance fund in 2016-17, it determined that local areas must instead invest in a wide range of NHS-commissioned services, including social care, in out-of-hospital settings.

The alternative option is to put an “appropriate proportion” of their share of the £1bn performance fund into a “local risk-sharing agreement” as part of contingency planning “in the event of excess activity”. The balance would also be spent on NHS out-of-hospital services, with areas seeking to maintain the provision of these services consistent with 2015-16.

But the policy paper also touched on the “unacceptable high levels” of delayed transfers currently, demanding that each local area must develop a focused local action plan to manage these figures, including a locally-agreed target.

This target must be agreed between the local CCG, local authority and relevant acute and community NHS trusts, with the figure then reflected in CCG operational plans. The metric for the target should be the same as the national performance metric, which states an average delayed transfers of care per 100,000 people per month (attributable to either the NHS, social care or both).

In drafting these plans, local areas must consider the use of local risk-sharing agreements referencing existing NHS England and Local Government Association guidance, especially in regions where delayed transfers of care levels are “high and rising”.

Plans must also set out clear responsibility, accountabilities, measures of assurance and monitoring, as well as demonstrate how activities across the whole health and care sphere can support improved patient flow and admissions avoidance. All community capacity should be effectively used to support safe and effective discharge, the department said.

This new condition of the £1bn funding pot is based on the principle that CCGs, councils and local trusts will work closely and collaboratively on this key issue.

(Top image: c. Design Council and Andy Smith)


There are no comments. Why not be the first?

Add your comment


national health executive tv

more videos >

featured articles

View all News

last word

The NHS needs more senior women in leadership

The NHS needs more senior women in leadership

The gender pay gap in the NHS remains a hotly debated topic, especially as the final report from the Gender Pay Gap in Medicine Review approaches. Andrea Hester, deputy director of employment relati more > more last word articles >

health service focus

View all News


Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professi... more >


How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to s... more >

the scalpel's daily blog

An ageing population means hand care and injury prevention is more important than ever

23/08/2019An ageing population means hand care and injury prevention is more important than ever

Grey Giddins, member of the British Society for Surgery of the Hand, discusses how hand care and injury prevention have become increasingly important given the UK’s agei... more >
read more blog posts from 'the scalpel' >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated that by the end of 2018 – the 70th birthday... read more >