Councils adult services departments will have to undergo peer reviews of their performance to avoid “large financial penalties” from failing to meet targets designed to foster integration with health.
The arrangement will govern the distribution of part of the £3.8bn integration transformation fund (ITF), a pooled budget that will be allocated jointly to councils and their local NHS clinical commissioning groups (CCGs) from 2015-16.
To access the fund, councils and CCGs must agree joint plans for their use that meet certain requirements (see below), but £1bn will be allocated on a payment-by-results basis: £500m distributed in April 2015 based on performance in 2014-15 and the second £500m allocated in the second half of 2015-16, probably on the basis of performance in the first half.
“In the event that the agreed levels of performance are not achieved, there will be a process of review, facilitated by NHS England and the Local Government Association, to avoid large financial penalties which could impact on the quality of service provided to local people,” said an update on the ITF issued last week by the LGA and NHS England.
The statement said the specific performance measures that would be used were under discussion, but would be restricted to existing national indicators so that performance between 2014-15 and 2015-16 could be compared.
Areas under consideration include delayed transfers of care, emergency admissions to hospital, admissions to residential and nursing care, patient and service user experience and effectiveness of reablement services. More outcome-based measures would hopefully be designed for use from 2016-17 onwards, said the statement.
Seven-day social care and integrated care planning
To access the fund, councils and CCGs must meet the following requirements:
- Plans for using the fund must be signed off by the local health and wellbeing board and, in agreeing the plan, councils and CCGs must engage with all relevant providers;
- Plans must set out how social care services in the area – but not levels of spending on them – will be protected; what constitutes protection of services will be agreed locally;
- Seven-day services must be set up for health and social care services to support patients being discharged from hospital and prevent unnecessary weekend admissions;
- The plans must provide for better data sharing about service users between health and social care, using people’s NHS number as a unique identifier;
- There must be a joint approach to assessments and care planning and service user must have an accountable professional where they are receiving an integrated package of care;
- The plans must lay out the impact of service changes on the acute hospital sector.
In each region a lead council chief executive will be appointed to work with NHS England’s area and regional teams and Association of Directors of Adult Social Services regional networks to help areas develop good plans and delivery arrangements. Where problems are identified, the LGA and NHS England will broker support for local areas.
The two organisations have asked health and wellbeing boards to fill in a template setting out their preparations to implement the ITF, covering issues such as their aims for integrated care, planned changes to services and how they expect to meet national requirements.
These should be returned by February 2014.