Social care will suffer as money goes back to the NHS
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A Government directive that local authorities must hand money they received through the Better Care Fund back to the NHS will put a huge burden on councils whose social care budgets are already constrained, says the Nuffield Trust.
Responding to the revisions to the Better Care Fund, set out by the Department for Health in early July, Dr Judith Smith of the Nuffield Trust said that, while sound in principle, the Better Care Fund had been built on unrealistic assumptions about the in-year savings that could be achieved by reducing emergency admissions to hospital.
“It’s therefore good to see that the Government has listened to the concerns we and others raised about the impact the Fund could have on hospital finances in 2015/16, which is looking to be a crunch year for the NHS,” said Dr Smith.
“But we should be under no illusion: the task ahead is not an easy one. The revised plan assumes reductions in emergency admissions of 3.5%, which would require local authorities and the NHS to buck a long-term trend.”
Dr Smith said that because the change to the Better Care Fund required local authorities to transfer money back to the NHS if emergency admissions were not reduced, it was likely that they would find themselves on the hook to hand up to £1bn back to the health service in a single year.
“This will come just as local authorities are using money transferred from the NHS to put in place new services for frail older people at risk of being admitted to hospital,” said Dr Smith.
“It has the potential to be hugely destabilising for local authorities, when they are already under intense financial pressure. The Government is right to be looking to boost out-of-hospital care to manage demand on the NHS but extensive evidence shows that this kind of change takes time. Expecting any savings in the short-term is looking increasingly unfeasible.”