Since the inception of the fund, the Welsh Government has made a total of £270 million available up to March 2019 and with a further £115 million allocation for 2019-20. The report finds that the fund has supported improved partnership working. But, despite some positive examples, its overall impact in improving outcomes for services users remains unclear.
The aim of the Integrated Care Fund is to drive and enable integrated working between social services, health, housing and the third sector and independent providers. The fund is distributed by the Welsh Government to seven Regional Partnership Boards (RPBs), which are aligned geographically to the seven health boards in Wales. Funded projects support people of different ages, with varying and often complex needs. The fund can support new initiatives, or extend existing ones to a broader area, with the intention that successful initiatives would be mainstreamed into organisations’ core business.
The report concludes that while the fund has supported better integrated health and social care services, there is little evidence of successful projects yet being mainstreamed into core budgets. Of the project leads surveyed, 75% identified that there were challenges in mainstreaming their project. The report also finds that the Welsh Government has not set any specific expectation on how to capture information about outcomes. While 87% of RPB members and 91% of project leads surveyed agreed that the projects funded were making a difference to service users, the Welsh Government and the RPBs recognise the need to strengthen outcome reporting and the Welsh Government intends to commission some wider evaluation work.
The report identifies opportunities to improve the way the fund has been managed and makes recommendations to the Welsh Government, working with the RPBs where relevant, around the following areas:
- Timeliness of guidance and decision making;
- Review of multiple short-term funds available to health, social care and housing organisations;
- Governance and scrutiny arrangements;
- Measurement of outcomes and general project monitoring; and
- Sharing of learning and mainstreaming of projects.
The Auditor General for Wales, Adrian Crompton said:
“The Integrated Care Fund has provided an impetus for partners to develop integrated health and social services and I am encouraged by the positive case studies identified by the Regional Partnership Boards. However, aspects of the way the fund has been managed at national, regional and project levels have limited its potential to date. With the Regional Partnership Boards taking on additional responsibilities, there are lessons to learn for this and other funding streams to get things right from the outset: being clear about expectations; providing timely guidance and appropriate planning horizons; and putting in place effective monitoring arrangements.
“I am pleased that the Welsh Government has already taken action to respond to some of the issues raised during the course of my work. The Welsh Government now needs to work with Regional Partnership Boards to agree how better evidence about the overall impact of the fund on service users will be gathered and to address my broader recommendations.”