Making best use of
the Better Care Fund
Richard Humphries
Assistant Director of Policy, The King’s Fund
Laura Bennett
Rese...
What is the Better Care Fund?
› £3.8 billion pooled budget for health and social care
› £1.9 billion from clinical commiss...
A resource for decision-makers
›

Health and care leaders are faced with the necessity of making
decisions based on the be...
1. The sources of need and demand
Targeting interventions where they can have most impact:
›

Increasing number of people ...
2. Primary prevention
Enabling people to enjoy a healthy and active life within their
communities:
›

Individual and commu...
3. Self-care
Supporting patients to manage their own condition:
›

Tailored interventions

›

Personalised self-management...
4. Ambulatory care-sensitive conditions
Active management of ambulatory care-sensitive conditions:
›

Early identification...
5. Risk stratification
Identifying individuals at high risk of future hospital admission:
›

Choose an appropriate predict...
6. Falls prevention
Screening, assessment and individualised intervention for those
at risk of falling:
›

Strength and ba...
7. Care co-ordination
Bringing services together around the needs of service users:
›

Holistic focus

›

Single entry poi...
8. Case management
Community-based, proactive approach to care:
›

Early action and prevention

›

Single point of access,...
9. Intermediate care
Rehabilitation and re-ablement to facilitate a stepped pathway
out of hospital or prevent deteriorati...
10. Emergency activity
Managing emergency activity, discharge planning and postdischarge support:
›

Capacity in the commu...
11. Medicines management
Managing the complexities and risks of polypharmacy:
›

Educational information and outreach serv...
12. Mental and physical health needs
Meeting the mental and physical health needs of patients and
service users:
›

Liaiso...
13. End-of-life care
Identifying and co-ordinating care for people who are at the end
of life:
›

Adequate capacity outsid...
14. Delivering integrated care
Well-developed, integrated services to provide a good patient
experience and reduce use of ...
More resources…
›

The house of care model (Coulter et al 2013)
www.kingsfund.org.uk/houseofcare

›

Sam’s story www.kings...
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Richard Humphries and Laura Bennett: Making best use of the Better Care Fund

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The £3.8 billion Better Care Fund is a single pooled budget to support health and social care services to work more closely together in local areas.

In this audio slideshow, Richard Humphries and Laura Bennett explore the different ways in which clinical commissioning groups, local authorities and health and wellbeing boards can use the grant to promote integrated care and help shift care closer to home.

Published in: Health & Medicine, Business
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Richard Humphries and Laura Bennett: Making best use of the Better Care Fund

  1. 1. Making best use of the Better Care Fund Richard Humphries Assistant Director of Policy, The King’s Fund Laura Bennett Research Assistant, The King’s Fund
  2. 2. What is the Better Care Fund? › £3.8 billion pooled budget for health and social care › £1.9 billion from clinical commissioning group allocations › Aim - to promote integrated care closer to home › Reduced hospital activity and income › Tough national conditions › Protection for social care services, seven day services, data sharing, joint assessments and care planning, impacts on acute sector, patient and public engagement › Tight timescales › First cut plan required by 14 February › Final plans by 4 April
  3. 3. A resource for decision-makers › Health and care leaders are faced with the necessity of making decisions based on the best available knowledge and evidence › Understanding of key local challenges and issues › Balance use of evidence with willingness to innovate and try different approaches
  4. 4. 1. The sources of need and demand Targeting interventions where they can have most impact: › Increasing number of people with multiple long-term conditions means patients’ needs are cut across multiple health and social care services › Small number of patients can consume a large proportion of services › Knowing who these people are is essential
  5. 5. 2. Primary prevention Enabling people to enjoy a healthy and active life within their communities: › Individual and community level interventions (advice, education, regulations) › Supporting people to maintain their independence (housing, preparing for winter, preventing isolation and loneliness)
  6. 6. 3. Self-care Supporting patients to manage their own condition: › Tailored interventions › Personalised self-management plan › Behavioural change programmes › Support for carers
  7. 7. 4. Ambulatory care-sensitive conditions Active management of ambulatory care-sensitive conditions: › Early identification (risk stratification) › Continuity of care with a GP › Early senior review and structured discharge planning
  8. 8. 5. Risk stratification Identifying individuals at high risk of future hospital admission: › Choose an appropriate predictive model and include GP data › Identify patients most likely to benefit from preventive care › Base catchment areas on distribution of high risk patients and consider local needs for staff mix › Organise around GP practices
  9. 9. 6. Falls prevention Screening, assessment and individualised intervention for those at risk of falling: › Strength and balance training › Home hazards › Vision › Medication review
  10. 10. 7. Care co-ordination Bringing services together around the needs of service users: › Holistic focus › Single entry point › Shared electronic health record - ‘high-touch, low-tech’ approach › Neighbourhood level › Engagement with GPs and secondary care
  11. 11. 8. Case management Community-based, proactive approach to care: › Early action and prevention › Single point of access, shared assessment and access to clinical records › Multi-professional teams based around GP practices › Holistic personal care plan › Case managers
  12. 12. 9. Intermediate care Rehabilitation and re-ablement to facilitate a stepped pathway out of hospital or prevent deterioration that could lead to a hospital stay: › Shared assessment and personalised plan to address physical, social and psychological needs › Appropriate skill-mix
  13. 13. 10. Emergency activity Managing emergency activity, discharge planning and postdischarge support: › Capacity in the community › Structured individualised discharge plan › Early supported discharge
  14. 14. 11. Medicines management Managing the complexities and risks of polypharmacy: › Educational information and outreach services › Use of IT and decision-making support tools › Longer GP consultations for patients with multiple long-term conditions › Improved systems for transfer of patient medication details at admission and discharge › Patient perspectives and challenges in managing their medications
  15. 15. 12. Mental and physical health needs Meeting the mental and physical health needs of patients and service users: › Liaison services › Improved identification and support of mental health needs among people with long-term conditions › Strengthened disease management and rehabilitation › Collaborative care models › Training
  16. 16. 13. End-of-life care Identifying and co-ordinating care for people who are at the end of life: › Adequate capacity outside acute hospitals to facilitate discharge › Rapid response services in the community to prevent emergency admissions
  17. 17. 14. Delivering integrated care Well-developed, integrated services to provide a good patient experience and reduce use of hospital beds: › Find common cause, develop a shared narrative and a persuasive vision › Establish a shared leadership and create time and space to develop understanding of new ways of working › Identify service users and groups where potential benefits are greatest › Build integrated care from the bottom up and the top down › Pool resources to enable commissioners and integrated teams to use resources flexibly › Innovate in the use of commissioning, contracting and payment mechanisms and the use of the independent sector › Recognise that there is no ‘best way’ of integrating care › Support and empower users to take more control over their health and wellbeing › Share information about users with appropriate information governance › Use the workforce effectively and be open to innovations in skill-mix (Ham and Walsh 2013)
  18. 18. More resources… › The house of care model (Coulter et al 2013) www.kingsfund.org.uk/houseofcare › Sam’s story www.kingsfund.org.uk/carestory › Integrated care map www.kingsfund.org.uk/caremap › Publications www.kingsfund.org.uk/publications

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