Government consults on pooled budget expansion plans

The government published its white paper on health and care integration – Joining up care for people, places and populations – in February 2022, promising to review the legislation covering pooled budgets covered by section 75 of the NHS Act 2006 and publish revised guidance. It said there was ‘scope to simplify and update’ the current mechanisms, which often involved unnecessary bureaucracy and obstacles to integration.

Setting out its ambition for pooled budgets at the time, it said that ‘wherever possible, pooled or aligned budgets should be routine … eventually covering much of funding for health and social care services at place level’.

And in April this year, the review by former health secretary Patricia Hewitt (pictured) – exploring what needed to happen to enable integrated care systems to succeed – called on the government to accelerate work to widen the scope of section 75 pooled budgets.

The government has now issued a consultation on how it might change the existing legislation to help expand the use of pooled budgets. In particular it is exploring:

• expanding the scope of section 75 to include additional health or public health-related functions of local authorities and NHS bodies
• allowing types of organisation to be involved with a pooled budget
• how regulations could be changed to overcome current barriers to pooling resources
• how governance could be strengthened or simplified

NHS functions currently considered to be in scope for pooled budgets include aspects of urgent and emergency care, hospital care, rehabilitation, mental health services and community health services. But the consultation asks for views on currently excluded services such as: emergency ambulance services; general surgery; radiotherapy; endoscopy; and class 4 laser treatments.

NHS Providers has previously warned against mandating the pooling of budgets. Addressing the new consultation,  Miriam Deakin (pictured), the representative body’s director of policy and strategy said section 75 arrangements could help to join-up working between the NHS and local councils. ‘[But] it’s vital that partners have clarity and support to encourage collaboration through robust governance, finance and contractual systems,’ she said. ‘With the NHS and councils under considerable financial pressure, NHS trust leaders’ experience of pooling budgets so far shows that both the NHS and social care need stable and sustainable financial positions to make most effective use of these arrangements.’   

She added that NHS Providers would be seeking ‘sufficient safeguards for local partners’ in any forthcoming national guidance. The consultation will run until the end of October.