Funding for joined-up health and social care still not signed off - six months into financial year

Councillors are being warned that there still could be risks to funding and that some of the work which should have been done, has not been completed.

At the heart of the national Better Care Fund is the priority to integrate local council services and local NHS services to “to join-up health and care services, so that people can manage their own health and wellbeing and live independently in their communities for as long as possible.”

But a report to this week’s Dorset health and wellbeing committee, which oversees the work, says there have been what it describes as ‘challenges in terms of progressing further integration of commissioning functions and the pooling of budgets’ – official language for ‘we haven’t completed this as quickly as we wanted to.’

It says that this is largely due to the planning guidance not being issued until July with plans having to be submitted regionally by the end of September – and, even then, the local plan had to go back to a national NHS team to be signed off, which is still not expected until mid-November. The delays have resulted in a minimum loss of seven months before local officials get final agreement for the local scheme, assuming they do.

The process has also been complicated by the formation of two new unitary councils in Dorset with neither having their corporate plans ready enough to coincide with the Better Care Fund scheme. One line in the report concludes: “The councils are still working on their new corporate plans and health and wellbeing strategies. The timetable for these has not matched the BCF planning process this year.”

This week’s Dorset health and wellbeing board is being asked to approve the BCF plan so that when the funding agreement is agreed, work can progress with an assurance that funding will be in place. For now work has continued but with no cast-iron guarantee of final funding levels.

A report to the board meeting in Dorchester tomorrow also warns that all the partners involved, principally the Dorset Clinical Commissioning Group and Dorset Council, are under “significant financial pressure in the face of growing demand and complexity of need.”

It says that this financial pressure could be detrimental to services in the long run – because any failure to meet the delivery targets of the Better Care Fund objectives could lead to less funding in the future.