The government having just made the biggest
re-organisation of the NHS is now insisting that local health and social care
economies now embark on another!
Health and Wellbeing Board which only came into existence
12 months ago are now developing plans to use the Better Care Fund. This fund is drawn from existing funds from
health and social care commissioners. The total could be around £4 billion for
England and in Buckinghamshire the fund will be nearly £100 million. This is
three times the size of the fund that other areas are implementing! Are they being too ambitious?
What will this fund do?
The Better Care Fund is to be used to integrate health
and social care services, especially for older people. It is hoped that this integration will reduce
costs and improve the quality of care (in that order).
Many of us have asked for a closer integration of health
and social care and so we should be welcoming this new work. But should the timer scale for developing the
project be longer than 12 months? Can
these new organisations, barely out of nappies, successfully implement such a
big change in the way services are commissioned?
Patients,
especially those with long term conditions & the elderly need care and support and
they get that support from many different agencies – the NHS, Social services,
the voluntary sector, the private sector, families and friends to name a few. Currently
some care is called health care and some is called social care. But patients don’t
really care what it is called. Or who commissions & funds it. What they want is for it to be provided
without any gaps, when and where they need it.
They don’t want to have to go to one lot of people for
one sort of care and then go through another assessment for more support! They just
want to go to one point to ask for help.
So this Better Care Fund sounds as if it a good idea. But
some say it will not save money and will not improve services. They say there is no evidence that it will
achieve these objectives.
I am also concerned that locally the public and patients
have not been involved in the design of this new service. As usual we will be involved and consulted
with in the middle of the process rather than at the beginning. Who is to carry out that involvement? It is Healthwatch Buckinghamshire who are
virtually unknown to the population of Buckinghamshire. Will they be able to carry out a meaningful
engagement with the public, let alone real involvement in the design of the new
service?
Finally who is going to manage this fund, who will monitor
the quality (and quantity) of the care? Who will be accountable?
It’s a mystery!
You can see the latest update on Buckinghamshire Health and Wellbeing Board's plans here
Here is a review of the evidence recently published by
the University of York which suggests that these schemes should be rolled out
cautiously and may increase overall costs.
