Better Care Fund to boost integrated health and social care

Newham Council's Health and Wellbeing Board has reviewed plans for the Better Care Fund (BCF) 2026-27, a significant pooled funding programme aimed at integrating adult health and social care services across the borough. The fund, which sits within Newham's Improving Outcomes Together Section 75 agreement, is set to receive a substantial £234.8 million for the upcoming year.

The BCF's strategic approach focuses on maximising integrated and preventative care, with a key objective to shift care from hospital settings to people's homes and from treatment towards prevention. This aligns with the Mayor of Newham's vision for the borough to be a place where residents can age well and where older and disabled individuals are supported to live independently.

Key investment areas for the BCF in 2026-27 include:

• Non-Elective Admissions and Proactive Care: A planned investment of £1.08 million in neighbourhood-based proactive care aims to contain the growth of non-elective admissions for those aged 65 and over to just 1% per year. This will be achieved through early intervention, community-based support, and identifying individuals at highest risk of hospitalisation. The proactive care will involve shifting support upstream: identifying and stabilising people at highest risk, responding earlier to deterioration, and connecting residents to practical and social support at an early stage including carers. Furthermore, it will support people with mental health issues, care coordination and proactively identifying and finding solutions for those most at risk of becoming high users of services, the funded approach will support more rapid and preventive assessment and intervention in the community, reducing hospital admissions and offering better continuity for people with multiple long-term conditions and/or frailty.

• Delayed Discharges: Significant investment is allocated to address delayed discharges, with £3.7 million for equipment, £637,000 for mental health step-down provision, and £143,000 for a homeless hospital team. These initiatives aim to reduce hospital bed days and ensure timely discharge. The homeless hospital team, comprising a Specialist Housing Advisor from the council and a Homelessness Pathway Coordinator from the Single Homelessness Project, will provide early identification of patients at risk of or experiencing homelessness and interventions to support them. All patients will have referrals to HPAS and a registered GP before leaving hospital, with Streetlink referrals made if required.

• Preventing Avoidable Long-Term Care Home Admissions: The BCF will support the Newham Living programme, which aims to develop new supported housing alternatives, including extra care schemes. An investment of £4.5 million is earmarked for capital allocation to create 24 new units. Newham opened Leacroft Lodge, a 48-bed extra care scheme, in 2025, which met care home levels of need. Demand for new care home placements reduced by 10% in the year Leacroft was mobilised, demonstrating its diversionary impact. The Newham Living programme aims to add a further 60 units over the next two years, with 60 new units in the pipeline ahead of 2028. Projections indicate a 30% increase in accommodation need for over-65s over the next decade, requiring approximately 250 extra care units to avoid residential care.

• Reablement Services: An enhanced reablement service, supported by an additional £283,000, will integrate occupational therapist and physiotherapist resources to improve quality and outcomes, aiming to reduce the need for long-term care packages. This investment is projected to save approximately £600,000 annually. Beyond financial savings, the service's effectiveness will be measured by improving the impact/outcomes, quality and timeliness of the offer. Specific anticipated improvements include reducing the number of people who require long term support and/or re-admissions and enhancing the impact/outcomes, quality and timeliness of the offer through dedicated and substantive therapeutic input.

The BCF's planned impact on achieving goals is detailed in the submitted narrative return, highlighting how investments in proactive care, intermediate care, and home-based services contribute to reducing hospital admissions and delayed discharges. The fund also supports the 50 Steps to a Healthier Newham strategy, focusing on tackling health inequalities and promoting prevention. This strategy aims to address health inequalities by tackling the wider social determinants of health alongside improving access to high-quality services, including targeted action to reduce the impact of poverty, poor housing, unemployment, social isolation, and barriers to healthcare that disproportionately affect many residents, particularly older people, ethnic minority communities, and those living in the most deprived neighbourhoods. The BCF contributes by investing in neighbourhood based proactive care and integrated reablement to reduce inequities, improve population health outcomes, and enable people to remain independent at home for longer.

Confidence in the value for money of BCF-funded services is underpinned by robust joint governance, including the Newham BCF Steering Group and the Urgent Care Working Group. These bodies ensure financial oversight, performance monitoring, and continuous improvement, with a strategic focus on shifting care to more efficient settings. Productivity is being enhanced through service transformation, integration, and a continued move towards home-based care. The Steering Group and Urgent Care Working Group will monitor the BCF's success in 2026-27 using metrics including admissions, discharge performance, and use of community services, with specific goals for Non elective admissions to hospital for people aged 65 and over and Average length of discharge delay for all acute adult patients. The plan also aims to maintain recent performance in discharges and reduce the average delay from Discharge Ready Date.