Ealing Council has approved a £60 million plan for the Better Care Fund (BCF) for the 2026/27 financial year, aiming to deliver integrated and preventative health and social care services across the borough with a significant focus on shifting services towards a neighbourhood health model.
The BCF plan, which has been submitted to and approved by the national team, outlines how Ealing will continue to invest in preventative services, the voluntary sector, and neighbourhood health initiatives. The pooled budget of approximately £60 million is allocated for residential care, prevention, intermediate care, and the Disabled Facilities Grant. The overarching goal of the BCF is to reduce hospital admissions, prevent admissions to care homes, and support residents to live independently for longer.
During a meeting of the Health and Wellbeing Board on Thursday, 10 September 2026, councillors received an update on the BCF. Avtar Maan, Head of Integrated Commissioning, presented the plan, highlighting that it reflects the ongoing integration of health and social care services and aligns with the NHS 10-year plan. He noted that a significant portion of the funding is dedicated to neighbourhood health services, early intervention, and prevention.
Specific Preventative Services and Neighbourhood Health Initiatives
A substantial amount, over £12 million, is earmarked for wider local support to promote prevention and independence.
This £12.1 million will be invested in a range of initiatives, including strengthening the voluntary sector through the joint Voluntary Sector Grants Programme to reduce health inequalities and poor mental health. It will also fund the Bridging and Accelerated Reablement Service, aiming to keep residents and patients in their own homes for as long as possible, supporting approximately 3,000 patients. Furthermore, the funding will provide community equipment for 13,000 residents and technology-enabled care for 2,400 residents to maintain independence. Support will also be provided for 100 patients with mental health step-down services to prevent re-admission and 40 units of bespoke step-down accommodation for homeless residents.
Measuring Success and Key Performance Indicators
The success of the BCF in reducing hospital admissions and care home admissions will be measured and reported through several mechanisms. The BCF plan includes setting improvement goals against three headline metrics: non-elective admissions for those aged 65 and over, discharge delays, and long-term admissions to residential and nursing care homes for people aged 65 and over. These metrics are developed using national datasets, local system intelligence, and modelling. Progress against these metrics is reported to the Ealing Health & Wellbeing Board, which provides statutory oversight. Additionally, the Section 75 Oversight Group reviews expenditure, budget monitoring, performance, and risk, while the Ealing Borough Based Partnership drives operational grip and delivery assurance.
Key performance indicators (KPIs) for assessing the effectiveness of integrated health and social care services include:
- Non-elective admissions to hospital for people aged 65 and over per 100,000 population.
- Discharge delays, measured by the proportion of people discharged by their Discharge Ready Date (DRD), the average length of delay, and the average number of days from DRD to discharge for those not discharged on time.
- Long-term admissions to residential and nursing care homes for people aged 65 and over per 100,000 population.
Impact on Demographic Groups
The BCF is projected to significantly impact specific demographic groups, particularly the elderly and those with disabilities, by enabling residents to live well, independently, and safely in their communities. The investment focuses on neighbourhood-level support for people with frailty, multiple long-term conditions, serious mental illness, homeless residents, and those at risk of losing independence. For the elderly and those with disabilities, the BCF aims to support independence and reduce reliance on acute care through reablement services, community equipment, and technology-enabled care. It also seeks to prevent re-admission for patients with poor mental health and support homeless individuals with bespoke accommodation. The Disabled Facilities Grant is ring-fenced to enable residents to stay independent in their homes, and the plan includes strengthening person-centred support planning and utilising voluntary sector assets. Furthermore, the Care Home In-Reach Liaison Service (CHILS) and enhanced training will support care homes in managing challenging behaviours, dementia, and end-of-life needs, helping to avoid unnecessary long-term placements.
Voluntary Sector Involvement
The voluntary sector will be a key partner in delivering integrated services, with a focus on strengthening its role through the joint Voluntary Sector Grants Programme to address health inequalities and poor mental health. While specific selection and funding criteria were not detailed, the emphasis is on culturally relevant, community-led activity that addresses barriers to health and wellbeing, ensuring accountability and shared decision-making. Phase 2 of the 'Ealing Roots & Wings' programme aims to establish a sustainable, Black-led alliance with formal governance and a ring-fenced collaborative projects fund. However, challenges such as short-term funding and underinvestment for Black-led organisations were noted.
Neighbourhood Health Model Implementation
The neighbourhood health model is a maturing system with established working arrangements, and the focus for 2026/27 is on sustaining and maturing neighbourhood delivery. The long-term goal for the neighbourhood health model is a 3-5 year vision that includes a greater proportion of spend in community-based services, staff working across organisations as single teams, and a network of Integrated Neighbourhood Teams (INTs). The phased rollout of initiatives like Child Health Hubs and Frailty Multidisciplinary Teams (MDTs) suggests a multi-year implementation.
Challenges and Mitigation Strategies
Potential challenges and risks associated with the shift towards a neighbourhood health model include health inequalities across neighbourhoods, increasing demand for mental health, children's, and frailty services, and the need for workforce and cultural adaptation. Building data, digital, and insight foundations is crucial, as is the alignment of finance and commissioning. While the voluntary sector is involved, greater neighbourhood-level involvement is a next step. Funding sustainability and improving communication with residents about service changes are also key considerations. Mitigation strategies include targeting investment in areas of highest deprivation, developing integrated neighbourhood teams, strengthening partnerships with the voluntary sector, and improving communication channels.
The plan is underpinned by a Section 75 agreement, which governs the financial and operational aspects of the pooled budget. The Health and Wellbeing Board has a statutory role in overseeing the delivery against the plan and understanding its impact on residents. Quarterly updates on the BCF's progress, including case studies and examples of its impact, will be provided. More information can be found in the Public reports pack for Thursday 10 September 2026.
