Responding to the National Audit Office’s report on the Better Care Fund, Nuffield Trust Chief Executive Nigel Edwards said:
“The NAO is right to highlight the over-optimistic assumptions upon which the Better Care Fund is built. We warned about these before. Reducing emergency admissions to hospital is very difficult. Even where it works, it takes a long time and doesn’t necessarily save money.
“The Government has taken steps to refine the policy after realising initial plans didn’t add up. But the scheme still banks on achieving a reduction in emergency admissions of over 3%. This is unprecedented in recent years. Because of the way the scheme is designed, missing the target will mean even more cuts to local authority budgets.
“The plan also emphasises the need to bring down delayed transfers from hospital to social care and reducing admissions to care homes. These are a better way achieve improved efficiency than the hope that pooled budgets will result in fewer emergency admissions to hospitals. Lasting change needs time to foster new ways of working and shared responsibilities across health and social care."
Notes to editors
The Nuffield Trust has evaluated more than 30 integrated care programmes, many of which had reducing urgent hospital admissions as a key goal. We have found little evidence of cost-effective reductions in hospital admissions from such initiatives.