Funding to encourage closer working between health and social care organisations in Lancashire has not been used to truly “transform” the system.
That was the message from Lancashire County Council’s adult services boss at a meeting of the region’s health and local government leaders.
Louise Taylor, who is also responsible for health and wellbeing, said there needed to be “a different discussion” about how money from the Better Care Fund (BCF) was deployed.
“I think we have been very pedestrian in how we have used the BCF - and not always within the spirit of it.
"I thought it was designed to be a transformational pot - but, if anything, I think it’s just been a transactional payment. People pay in and then I give you back.
“Really, we ought to be using that money to say how we want to transform the types of care we offer - and that’s the vehicle through which we could do it,” Ms. Taylor told Lancashire’s health and wellbeing board.
The BCF was set up in 2013 as a pooled pot of money which was to be shared between Clinical Commissioning Groups and local councils. It has continued ever since, but it represents money which was already in the system and not additional funding.
The so-called Improved Better Care Fund (IBCF) is extra cash that was allocated as part of the government’s pledge to put £2bn into adult social care in the March 2017 budget.
Lancashire pooled £119m of money under the BCF between 2017/18 and 2018/19 and received £46m of IBCF funding over the same period.
BCF cash has been used for projects including telecare - the use of technology to monitor vulnerable people’s safety at home - and reablement services to help patients live independently after a period of ill health.
IBCF money has been put into schemes including the Home First programme of assessing social care needs in a person’s home rather than hospital and also to set up intermediate care outside the hospital setting.
The IBCF’s future is uncertain, as its funding was intended to be a one-off. However, the government has since announced other ad hoc social care grants for local councils and is due to publish a consultation on the future of the social care system.
Lancashire was threatened with having some of its IBCF allocation clawed back by the government last year over slow progress in meeting targets to reduce hospital discharge delays. However, the county hit the required standards by the summer and retained its entire share.