Clients to receive joint assessments and lead professionals through £3.8bn pooled budget

Councils and NHS would have to meet a range of conditions to access integrated budget designed to keep older and disabled people out of hospital.

Health and social care service users would receive joint assessments and lead professionals to co-ordinate their care under government plans to set up a £3.8bn pooled budget across the two services in 2015-16.

The plans were unveiled today by the Local Government Association and NHS England in a statement providing initial details on how councils and CCGs would be able to get hold of the full integration transformation fund (ITF), access to which will have to be approved by ministers.

The funding was announced in June in chancellor George Osborne’s spending round to support community-based integrated care for and reduce hospital bed use for older and disabled people.

Last week, health minister Earl Howe revealed that £1.9bn would be drawn from spending already planned for 2014-15 across health and social care, including the annual transfer of resource from the NHS to councils to spend on adult care services that promote integration, worth £1.1bn in 2014-15.

The remaining £1.9bn is money that would otherwise have been paid to clinical commissioning groups for health spending, but will be reallocated by ministers to the pooled budget. The LGA and NHS England said that to access the ITF, councils and CCGs would have to draw up joint plans by March 2014 for using the integrated care funding in both 2014-15 and 2015-16. These would have to meet the following conditions:-

  • Access to social care should not be restricted in 2015-16 compared with 2014-15;
  • Some money should be set aside to deliver new duties on councils from April 2015 in the Care Bill;
  • A joint approach to assessments and care planning would be implemented for people with health and social care needs;
  • Where people are receiving integrated packages of care, they should have an accountable professional;
  • Seven-day working would have to be implemented across health and social care to support hospital discharge and prevent admissions at weekends;
  • Data sharing would need to improve based on people’s unique NHS number;
  • All plans would have to be agreed by the council, the CCG and the local health and well-being board.

In addition, access to £1bn of the ITF in 2015-16 would be based on performance against a set of national and locally chosen targets, with half of this paid in April 2015, based on performance in 2014-15, and the remainder paid half-way through 2015-16 based on performance in the first part of the year.

The ITF is designed in part to compensate councils against wider cuts in government funding, but even when it is taken into account, town hall budgets are due to fall by 2.3% in real terms in 2015-16. 

As CCGs would be losing money that would otherwise be allocated to them, the LGA and NHS England said they would have to manage this by reducing spending on existing NHS services, particularly acute hospitals.

The LGA and NHS England said they – and the Association of Directors of Adult Social Services – would start working with local councils and CCGs this autumn to help them develop plans for using the ITF.

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