The BCF was launched in 2015 to encourage integration by requiring clinical commissioning groups (CCGs) and local authorities to enter into pooled budget arrangements and agree an integrated spending plan. It aims to support person-centred care, sustainability and better outcomes for people and carers in line with the vision outlined in the NHS long term plan. There is a key focus on prevention, independent living at home, avoiding admissions, enablement and discharge from hospital.
The aim of the pooled budgets is to reduce the barriers often created by separate funding streams. It is a combination of contributions from the following areas:
- minimum allocation from NHS clinical commissioning group(s) (CCGs)
- disabled facilities grant – local authority grant
- social care funding (improved BCF) – local authority grant
- Winter pressures grant funding – local authority grant.
There are four partners to the initiative:
- The Department of Health and Social Care
- Department for Levelling Up, Housing and Communities
- NHS England and Improvement
- The Local Government Association
BCF plans are agreed at Local Authority level and signed off at Health and Wellbeing Boards, so there is a clear link to PLACE within the new ICS architecture. It does not appear clear how the new arrangements for a single accountable person at PLACE level will impact on this process. The government sets the national policy conditions and outcome matrix for the BCF. More work is also required to determine the reporting data required from Local Authorities and others and how BCF plans will feed into and align with the strategic plans of systems.
Currently, the BCF is ring fenced as part of the financial allocation to CCGs and it has to be used to deliver outcomes of the Health and Well Being Board. Systems will need to work out how processes align going forward. Work is also required to align the governance requirements for new ICS national and local shared outcomes with this process.
Further details, including details of the regional BCF managers are available on the NHS website: https://www.england.nhs.uk/ourwork/part-rel/transformation-fund/better-care-fund/about-the-better-care-fund/