Much NHS money provided to councils is being used to stave off tighter thresholds on access to adult care services rather than invest in integrated care, a report has found.
The finding raises doubt about the potential of the Better Care Fund – a £3.8bn pooled budget between councils and the NHS from 2015-16, largely made up of health service resources – to deliver more integrated services, said the study.
The All in This Together? report by communications consultancy MHP Health examined how 138 English local authorities used the money they received from the NHS in 2012-13 and 2013-14, worth £622m and £859m respectively.
The government-ordained transfers, which began in 2011-12, are designed – ordained by government – is designed to support social care services that benefit health, and its use should be agreed by local NHS partners.
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, MHP Health found that maintaining the eligibility criteria for existing services took the largest share of the money provided through the fund with 23% of the money being spent on this in 2012-13 and 24% in 2013-14. This is equivalent to £349m across those two years.
Preventative services, including telecare and rapid response services, received the next largest chunk of funding with 23% in 2012/13 and 22% in 2013/14. Spending on reablement services accounted for another 20%.
Mental health services received less than 4% of the money in both 2012-13 and 2013-14, despite the government’s aim of achieving parity of esteem between physical and mental health services.
Richard Sloggett, associate director of MHP Health, said the lack of new collaborative services resulting from the fund raises doubts about whether the Better Care Fund can deliver more integrated care.
“This research raises serious questions about whether the Better Care Fund will be used to deliver truly integrated local services or as a means to prop up existing social care services,” he said.
“If local health and care commissioners are to draw up informed plans about how the Better Care Fund will be used, there is a real need for greater evidence about the cost and impact of interventions that support integration.
“There must also be an informed dialogue about local priorities and a robust assessment of the impact of the transfer fund from the NHS to local authorities has had in the area – which our research reveals has been mixed.
“This is essential if truly collaborative and integrated health and social care services are to be delivered.”
Councils are receiving £1.1bn from the NHS to support social care in 2014-15, and the government has directed that at least £200m must be used for the purpose of service integration, a condition that has not applied in previous years.
There will be even tougher conditions on the use of the Better Care Fund, which must be put into a formal pooled budget between local authorities and their clinical commissioning group partners; be used to provide seven-day-a-week social care support for people being discharged from hospital and at risk of unnecessary admissions, support better data sharing and integrated assessments between health and social care.
However, another condition of the use of the fund is to protect social care services from reductions in the level of service.