Recommendation 20

HM Government · verbatim extract Not Addressed

The government accepts this recommendation. The government set out in the 10 Year Health Plan that we are committed to reforming the BCF to provide a more consistent and effective approach to finding services that is essential to delivery in a fully integrated way. As a first step in this reform journey, we are making changes to the BCF in the 2026 to 2027 financial year to help local areas go further in joining up delivery of health and social care services, in line with the government's objectives for neighbourhood health and for devolving more responsibilities. The arrangements for this are set out in the better care fund framework 2026 to 2027. The aim of the BCF is to support ICBs and local authorities in designing and delivering more integrated and preventative care, particularly for people with more complex health and social care needs, helping people stay independent for longer. This includes - but is not limited to - developing integrated intermediate care services that help people retain or recover their independence. It also covers other health and social care services that support independence, prevent avoidable admission to hospital or long-term residential care, and enable timely and effective acute, community and mental health hospital discharge. BCF funding should be deployed in ways that help deliver the 3 shifts (from hospital to community, from analogue to digital, from sickness to prevention) outlined in the 10 Year Health Plan. The government is increasing the NHS minimum contribution to adult social care between 2026 to 2027 and 2028 to 2029 in line with the Spending Review settlement. In 2026 to 2027, the NHS minimum contribution to adult social care has been uplifted by 4.4%, with the remaining ICB contribution uplifted by 2.1%. On 9 February 2026 the Ministry of Housing, Communities and Local Government (MHCLG) confirmed the value of the local authority better care grant for each local authority and will shortly do so for the disabled facilities grant. The 2026 to 2027 local authority better care grant allocations will be the same as the local authority better care grant in 2025 to 2026. ICBs and local authorities can also voluntarily pool additional funding through the BCF where they are assured this represents value for money, as in previous years. For 2027 to 2028 onwards, we intend to consider whether local areas should be given more flexibility in deciding the level of pooled funding needed to support better integrated services. There will be consultation on any proposed changes to minimum NHS and local authority contributions. We will also work with the NHS and local government to develop clearer expectations for the types of services that as a minimum should be subject to pooled funding. This will build on the success that many local areas have already seen by taking a more strategic approach to pooled funding.