All councils must draw up health and social care integration plans by 2017

As well as confirming the fact that councils will be able to raise council tax by up to 2% as part of a new social care precept, chancellor George Osborne has also announced social care funds for local government as part of the Better Care Fund.

As part of his Spending Review, Osborne will pour £1.5bn into the Fund and make it available to local government in order to allow councils to finance social care.

In his announcement, he said: “The truth we need to confront is this: many local authorities are not going to be able to meet growing social care needs unless they have new sources of funding.”

And the social care precept, revealed earlier this week, could help raise an extra £2bn a year by 2019-20 if councils “use this to its maximum effect” and exclusively on social care.

According to Whitehall, if these two new measures are taken together, councils would be able to increase social care spend in real terms by the end of the Parliament.

“This will support councils to continue to focus on core services, and to increase the prices they pay for care, including to cover the costs of the national living wage,” the Spending Review document said.

But new tax raising powers will also be off-set by a significant reduction of central government grants to local authorities.

The government has also pledged to deliver over £500m by 2019-20 for the Disabled Facilities Grant, which is expected to fund around 85,000 home adaptations and prevent 8,500 people from needing to go into a care home that year. An investigation published last week also provided new evidence that this grant could be used to mitigate growing pressures on council social care budgets.

Whitehall has also reiterated its commitment to introduce the Dilnot reforms to social care, pledging funding in 2019-20 to cover the costs of councils preparing for these changes. The care cap will then be introduced and funded from April 2020.


As well as increasing and opening up the Better Care Fund for local government, the chancellor will force every part of the country to have a plan for integration between social care and the NHS by 2017, to be implemented by 2020.

This is part of a commitment to ensure the two sectors are fully integrated by the end of this Parliament, something that  has consistently topped council and health leaders’ agendas in recent months.

Areas will then be able to leave the existing Better Car Fund programme management once they demonstrate that they “have moved beyond its requirements” by meeting the government’s criteria for devolution.

But Whitehall will not impose how the NHS and local government deliver this integration, since the way it is implemented on the ground will vary between each local area.

The Spending Review document cited examples of this integration already taking place in some parts of the country, including through Greater Manchester’s £6bn health devolution deal.

It also referenced Accountable Care Organisations, such as the one being formed in Northumberland, which seek to create a single partnership overlooking health and social care needs. PSE’s sister title NHE will further discuss these organisations in its upcoming November/December edition.

And lead commissioners, such as the NHS in north east Lincolnshire, are already spending all health and social care cash under a single local plan, the government said.


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