What is the Better Care Fund? A guide for health and care organisations

What the Better Care Fund is

The Better Care Fund (BCF) is a shared funding pot established in 2013 and operational since 2015–16, jointly overseen by NHS England and the Department of Health and Social Care (DHSC). Its purpose is to encourage NHS bodies and local authorities to pool budgets and commission health and social care services in a more coordinated way — reducing unnecessary hospital admissions, supporting people to live independently, and reducing duplication between the NHS and council-commissioned care.

The BCF is not a grant scheme where organisations apply for individual project funding. It is a system for aligning existing resources: NHS England mandates that Integrated Care Boards (ICBs) and their partner local authorities contribute specified minimum amounts into a pooled arrangement, governed locally by the Health and Wellbeing Board.

How the BCF works

At a national level, NHS England sets BCF policy, the minimum contribution requirements, and the national conditions that local plans must meet. At a local level, each area prepares a BCF plan agreed between the ICB and local authority, signed off by the Health and Wellbeing Board.

The BCF has three mandatory components:

• NHS minimum contribution— Each ICB is required to contribute a minimum sum into the local pool, calculated on a nationally set formula. This money must be used for social care services that also benefit the NHS — for example, reablement, step-down care, or home care that prevents hospital readmission.
• Disabled Facilities Grant (DFG)— Capital funding distributed through the BCF to local authorities to fund home adaptations for disabled people. Local authorities administer DFG but the allocation flows through the BCF framework.
• Additional local contributions— Local areas may agree to pool further NHS and local authority resources beyond the mandatory minimum, enabling broader integrated commissioning of community health, mental health, or social care services.

Local BCF plans must meet national conditions, including maintaining social care spending at a minimum level (to prevent NHS money substituting for council funding), and demonstrating progress against agreed metrics such as non-elective admissions and delayed transfers of care.

Who is involved in BCF governance

The governance structure for the BCF at local level involves several key bodies:

What organisations can access through the BCF

Providers do not directly “bid” for BCF money in the same way as a grant. Access to BCF-funded services comes through commissioning relationships with ICBs and local authorities. If a local BCF plan includes, say, expanded reablement services or a new step-down bed capacity programme, providers may be commissioned to deliver those services through standard NHS and local authority procurement routes.

Organisations that can benefit from BCF-funded commissioning include:

• Domiciliary care and reablement providers contracted by the local authority
• Care homes with nursing providing step-down and intermediate care capacity for NHS-funded patients
• Community health providers delivering BCF-funded integrated community teams
• Voluntary sector organisations delivering prevention and social prescribing services
• Technology and digital health companies whose products support BCF-aligned outcomes such as hospital avoidance or remote monitoring

The practical route in is through engagement with both the ICB commissioners and the local authority commissioning team. Understanding the local BCF plan — what priorities have been agreed, what services are being expanded, and what metrics the local area is being held to — is the prerequisite for a credible approach to either body.

How the BCF relates to adult social care commissioning

The BCF sits within a broader adult social care commissioning landscape in which local authorities hold the statutory duty of care under the Care Act 2014. The BCF does not transfer that duty — it creates a financial and planning mechanism to align NHS and council resources in pursuit of shared outcomes.

In practice, BCF-funded services often sit at the interface between NHS and social care: reablement, intermediate care, discharge-to-assess, home care packages supporting hospital discharge, and care home capacity for people who are medically fit for discharge but cannot return home. These are precisely the areas where the NHS-social care boundary has historically caused delayed discharges and system inefficiency.

For providers and organisations operating in these areas, the BCF is a significant commissioning driver. Understanding how the BCF plan in your area is structured — what the ICB and local authority have agreed to prioritise, and what the national conditions require them to demonstrate — is essential context for any engagement with commissioners.