The Better Care Fund has been criticised by MPs as ‘deeply flawed' as a report into its progress found issues with planning and NHS spending prioritised over adult social care.
The £5.3 billion Better Care Fund was introduced as an opportunity to transform local health and social care services by pooling resources to stimulate closer joint working for local populations and the taxpayer.
Margaret Hodge, chair of the Public Accounts Committee which launched the report into the Better Care Fund said: "With the redesign of the Fund after April 2014, the priority has shifted from improving local services through integration to protecting NHS resources. It appears to the Committee that NHS spending was judged a higher priority than supporting adult social care."
"The initial planning for the Fund was deeply flawed. Whilst NHS England and the Department of Health worked on a planning assumption that the Fund would secure £1 billion in financial savings for the NHS, the Department for Communities and Local Government had not worked on the basis of a required savings target."
The report found a lack of clarity with local areas about expected savings "severely undermined" the initial planning.
It was revealed that the Department of Health. the Department for Communities and Local Government (the Departments) and NHS England changed the rules in the middle of the planning phase, after failing to tell planners they needed to identify £1 billion in savings.
When local plans were stress tested, savings of just £55 million were identified - nowhere near £1 billion.
Meanwhile, the arrival of NHS England's new chief executive in April 2014 created a stimulus for the pause and redesign of the Fund, leading to the requirement that £1 billion be protected for the NHS.
As a result, all 151 health and wellbeing boards had to submit revised plans, resulting in wasted time, effort and money. The latest plans suggest that local areas expect to pool £5.3 billion and save £532 million in 2015-16.
The report said: "We are not convinced that it is possible to reduce emergency admissions and to deliver £532 million of savings in 2015-16, as the scale of the challenge in reversing the long-term upward trends in emergency admissions and delayed discharges is significant.
"The Local Government Association considered that the redesigned scheme moved the integration agenda backwards and not forwards, and it told us that local government had contemplated walking away from the Fund. Local areas are now at greater risk of not being able to implement the policy."
Meanwhile, it is also unclear how local authorities will protect adult social care services to the extent intended, the report warned.
At the time of the hearing, fourteen local plans presented serious concerns with regard to the protection of adult social care in those areas, the report said.
It added that "demographic changes mean demand for adult social care services is increasing at a time when available resources are shrinking."
The report recommended that "all the agencies involved need to rise to this challenge as failure, particularly for older and disabled people, is not an option."
The Departments should publish an annual scorecard to demonstrate the extent to which the Fund is supporting integration, maintaining adult social care, reducing emergency admissions and saving money, it added.
