£5.3 billion fund to cut bed-blocking 'just a ruse' to plug council budget gaps, MPs find

Sarah Knapton
A fund to bring social and healthcare together has not met a single target, MPs have warned  -  Lynne Cameron

A £5.3 billion government pot to integrate health and social care has not achieved a single target and is ‘little more than a ruse’ to plug gaps in local authority budgets, MPs have warned.

In 2015, the Department of Health set up the Better Care Fund with the intention of cutting down emergency admissions and bed-blocking, where patients are medically fit to leave hospital but there are delays to arranging their social care in the community.

However in a damning report the Public Affairs Committee found that the fund was ‘little more than a complicated ruse to transfer money from health to local government to paper over the funding pressures on adult social care.’

MPs also said that administrators had displayed ‘an appallingly casual attitude’ to targets which had been set for reducing emergency admissions and bed blocking, both of which had actually increased.

Liz McAnulty, Chair of the Patients Association, said: “The Better Care Fund was always pretty plainly a way of shifting funds from the NHS to social care.

"The crisis in social care funding had been brewing since at least the turn of the decade, and the BCF was always a sticking-plaster solution rather than the commitment to adequate funding of social care that was really needed.

“We believe that the current funding settlement for health and social care must be revisited, as it is plainly proving inadequate.”

Bed blocking has got worse since the fund launched  Credit: PA

In the first year of the fund local areas planned to reduce emergency admissions by 106,000, saving £171 million. However, in 2015/16, the number of emergency admissions increased by 87,000 compared with 2014/15, costing a total of £311 million more than planned.

Under original plans, bed-blocking should also have fallen by a total of 293,000 hospital days but it actually increased by 185,000 compared with 2014/15, costing a total of £146 million more than planned.

The government said the fund would help achieve savings of £511m in the first year, but this was not realised.

The PAC concluded: "Two years ago, we expressed serious doubt that the government’s latest integration initiative, the Better Care Fund would save money, reduce emergency admissions to hospitals and reduce the number of days people remain stuck in hospital unnecessarily.

"Since then the Fund has failed to achieve any of these objectives and our witnesses displayed an appallingly casual attitude to the targets that had been set for reducing emergency admissions and delayed transfers of care, both of which have actually increased.

"The NHS must find better ways to engage more genuinely with local government and local populations."

In February a report by the National Audit Office warned that there was “no compelling evidence” to show that integrating services “leads to sustainable financial savings or reduced hospital activity”.

The NAO also said that almost £2 billion set aside to help integrate services had actually been used to plug deficits at NHS trusts.

The Department of Health said it could not comment on the report because of purdah rules ahead of the general election. 

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