Better Care Fund Support Programme (2023-2025) Findings

Ipsos UK, in partnership with the Institute of Public Care at Oxford Brookes University (IPC), was commissioned by the Department of Health and Social Care (DHSC) to conduct an evaluation of the Better Care Fund Support Programme. The Better Care Fund (BCF) Support Programme was set up to ensure that local areas have the right support available to them as they work towards delivering their Better Care Fund plans.

DHSC has now published the findings from the Evaluation of the Better Care Fund Support Programme 2023 to 2025. The support provided by the programme was delivered to local systems ( Intergrated Care Boards and local authorities, working together in health and wellbeing board areas with VCSE and housing partners) by the Local Government Association (LGA), supported by local providers.

The evaluation focused on:

• The design and delivery of the support programme
• Outputs and outcomes from individual support projects at a local level, including upon system integration and service users
• Any aspects of good practice and learning that can be scaled up and used to improve the support programme

Key findings 

Engagement with the support programme

As of 13 January 2025, 28 universal support projects and 65 local support projects had been completed, with a further 5 universal support projects and 10 local support projects in active delivery.

Of the 65 completed local support projects, most related to capacity and demand planning (25) or scoping and diagnostic reviews (15). 50 were referred through directed support and 15 were referred through non-directed support (meaning that the system sought support independently). Barriers to taking up support include perceived duplication with other support and activities and lack of capacity and coordination which resulted in 27 support offers being declined or closed down.

Support delivery

Scoping is a key stage of the support offered and was found to be helpful for clarifying needs and setting expectations.
Engagement with the main support delivery was affected by the perceived credibility of the support, existing relationships and time and resource constraints. There was limited involvement of VCSE organisations and housing partners in support delivery, related to capacity constraints and lack of awareness of the support.

Outcomes and impact of the support programme

While there is some evidence of improved inter-agency relationships, development of joint plans and changes in investment decisions as the result of support, evidence related to tangible system improvements or impacts for people drawing on support from the health and social care system is limited. 

This reflects the stage at which this evaluation has taken place - it is too soon to measure most of the medium to long-term impacts of the support programme. Also the nature of partner relationships and other factors such as resource constraints makes bringing about system change complex and difficult.

Systems often acknowledged the value of the support and the recommendations provided but struggled to translate these into sustained action. This was particularly true in systems lacking dedicated staff or funding for transformation work. The systems where progress was most evident tended to be those where there is strong governance and leadership.

Improvements and implications for the support programme

• Provide clearer communication about the support programme's purpose, process and expected outcomes.
• Tailor the support offer to individual system needs and specific challenges. Consider maturity levels and offer proactive, positive offer for ambitious systems.
• Provide regional BCMs with the resources and remit to engage more proactively with the support needs of their local systems and the support programme.
• Establish peer learning opportunities and networks for senior leaders and BCMs to share best practices and learn from each other's experiences.
• Offer implementation support to help systems translate recommendations into action and connect systems with implementation experts and peer networks.
• Emphasise and support leadership, culture, collaborative working and behaviour change in driving successful BCF implementation through support offers.

Technical details 

The methodology for the evaluation of the support programme reflects that it was a process evaluation with elements of impact measurement at the local system level. For example, case studies detail the wide range of impacts of support projects delivered across particular systems. 

The methods included:

• Case study interviews with systems (16 in phase 1 and 15 in phase 3 across 14 systems).
• A review of supplementary evidence provided by systems.
• Interviews with 9 Better Care Managers (BCMs) and 5 Care and Health Improvement Advisers (CHIAs) at phase 2.
• Five interviews with non-participating systems at phase 2.
• A survey of 38 BCF leads within systems. Note that this sample cannot be considered representative of all systems. The tables are provided below. Caution should be exercised in interpreting findings.
• Areview of management and key performance indicator (KPI) information.