30.10.14
Better Care Fund boosted to £5.3bn to deploy 18,000 community workers
The Better Care Fund is to be boosted to £5.3bn a year to help join up health and care services, Jeremy Hunt announced last night.
The extra £1.5bn, on top of the original £3.8bn, is reportedly to come from more pooling of local budgets – it is not new money.
The health secretary said the money will be invested in 151 plans across the country to help keep the elderly at home and healthy and avoid needless hospital and care home admissions. As part of the plan an extra 18,000 community workers will be “deployed” to provide care.
Hunt said that the plans are “the first step towards wholly integrated care” and will lead to 160,000 fewer emergency stays in hospital, saving more than £500m a year.
Writing in the Telegraph, Hunt set out his ambitions for a new model of care for the NHS, which mirrored his words to the Best Practice Show last week, previously reported by NHE.
“The first pillar of our plan is to change the basic NHS model from one centred on hospital care to one that helps people stay healthy and happy at home. Prevention is better than cure – not just for the patient, but for the NHS that picks up the tab when things go wrong,” he wrote.
At Best Practice he went a step further, setting out his plan for how he sees CCGs taking the lead, working with many other organisations in commissioning all health services in their area.
“I’d like to see that go much further. I’d like to see CCGs clinically led becoming Accountable Care Organisations, responsible for all the care of the populations they look after,” he said. “Not just commissioning secondary care but with the Better Care Fund co-commissioning social care, with NHS England co-commissioning primary care and with local authorities co-commissioning public health. Because I think we have to join this up and we have to think about healthcare much more holistically that has happened in the past.
“One of the points in the NHS England Five Year Forward View was the very strong comments about doing more about obesity. We really need to link up the public health campaigns conducted by national and local government with the work done by GPs and practice nurses in GP surgeries. I think CCGs can be the spider in the centre of the web, working closely with lots of other people, and the Better Care Fund is a fantastic example of the way that kind of innovation is starting to happen.”
The health secretary talked about two other pillars in the government’s plan for the NHS, the first of these being embracing innovation and technology. Hunt wrote that the health service needs to learn the lessons of the technology revolution, just as the bank, travel and retail businesses have.
He told an audience of family doctors last week: “A really good example of what we could easily be doing with technology is, with a patient’s permission, allowing a pharmacist to access their GP record so that they can see their medication history, their allergies and make sure that they give them exactly the right medication. There are suggestions that we could save 20% of GP visits, and GPs are very hard pressed at the moment.”
The final and “most important but also most difficult” pillar is to change the culture in the NHS. He wants to move away from a target-driven culture to one led by transparency and peer review, with the primary accountability of clinicians being towards patients rather than the goals of the organisations they work for.
Hunt added: “We now have on the My NHS website data about comparative performance of hospitals and local authorities that is more open and more transparent than any healthcare system in the world. I think as we become more comfortable with transparency we’ll be able to use fewer targets. Because most of the time if people understand how well they’re performing compared to their peers, they want to learn.”
Responding to the Better Care Fund announcement, National Voices’ welcomed it as a step in the right direction, but also warned that it is only one of a number of efforts to encourage integration of health and social care and that these need to be co-ordinated.
Chief executive of the charity, Jeremy Taylor, said: “The Better Care Fund is a step in the right direction and there is lots of enthusiasm across the country to join up services. However, three things are now key to making this happen.
“We need to keep the emphasis on people, improving the quality and experience of care - we mustn’t let the current focus on saving money and reducing hospital admissions detract from this.
“Local areas need support to get involvement right. The best local plans involve not just doctors and nurses but people who use services, family, carers, friends, volunteers and charities and community groups. There are some great examples of this but they are far from the norm.
“Finally, the Better Care Fund is just one of a number of national efforts encouraging integration of health and social care services and we worry that energy and money are being dissipated among too many initiatives: the Government and its national partners need to coordinate their own efforts to coordinate services.”
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