Health and Care Bill: service integration – the Better Care Fund (BCF)
Updated 10 March 2022
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This fact sheet explains how the government plans to establish a new power for the Better Care Fund (BCF) to separate its legal basis from that of the mandate to NHS England. This is a technical change that will not impact the operation or policy intention of the BCF.
Background
The BCF is a national policy driving forward the integration of health and social care in England. The BCF requires Clinical Commissioning Groups (which, through the Bill, will be abolished to be replaced by new Integrated Care Boards (ICBs)) and local authorities to make joint plans and pool budgets for the purposes of integrated care, providing a context in which they can work together, as partners, towards shared objectives.
The BCF continues to move integration forward by enabling greater cooperation between health and social care partners at a local level. In 2019, 93% of local areas agreed that joint working had improved as a result of the BCF.
What the Bill will do
Currently, the government’s mandate to NHS England can require it to set a national amount that the NHS must contribute to the Better Care Fund (BCF).
Other provisions in the Bill will remove the requirement for a new mandate to be published every year. As a result, the mandate will no longer be an appropriate vehicle for setting an annual ring-fence for service integration.
Instead of using the mandate to set the BCF, the Bill will put in place a new power allowing the Secretary of State to direct NHS England to ring-fence an amount of its annual allotment for service integration. Secretary of State will also have powers to direct NHS England on how that amount should be used. Moving to a separate provision will make sure the BCF can continue to be set annually and function as it currently does.
This is a technical change that will not impact the operation or policy intention of the BCF. How will these provisions help to promote integration?
The government remains committed to person-centred integrated health and care, including through the BCF. These provisions will allow the Secretary of State to continue directing NHSE to ringfence funding to be used for integration purposes.
Further information
NHS Long Term Plan, January 2019
Department of Health and Social Care, Integration and innovation: working together to improve health and social care for all, February 2021
Government’s 2021 to 2022 mandate to NHS England and NHS Improvement