The Kent Health and Wellbeing Board considered proposals to strengthen governance of the county’s Better Care Fund, which totals nearly £239 million for 2026/27 and is committed in full to existing services.

A pooled budget of £238,857,022 supporting health and social care services across Kent could receive strengthened joint oversight under proposals considered by the Kent Health and Wellbeing Board when it met on 30 September 2026.

The Better Care Fund (BCF), a national programme that brings together NHS and local authority money, is held in a pooled budget hosted by Kent County Council under a Section 75 Partnership Agreement with NHS Kent and Medway Integrated Care Board (ICB). The 2026/27 total comprises £153,117,150 from the ICB, of which £51,492,794 is dedicated to adult social care.

The fund supports a range of services including prevention, intermediate care and reablement, hospital discharge, carer support, assistive technology, equipment, housing adaptations and services enabling people to remain independent at home. Officers noted that all funding within the current plan is committed to existing services, with no additional or uncommitted money available.

New governance structure proposed

A report to the board set out proposals for a new Section 75 Partnership Board to provide joint strategic oversight of the Kent BCF, subject to approval of a revised Section 75 Partnership Agreement through KCC and ICB governance processes. The Partnership Board would oversee use of the pooled fund, monitor delivery against the approved plan and consider performance, financial position, risk, productivity and value for money.

A supporting BCF Programme Board would undertake more detailed oversight of individual schemes and escalate issues requiring strategic consideration to the Partnership Board. The Health and Wellbeing Board itself would retain strategic oversight, receiving quarterly reports on performance, finance, delivery and risk, and would be asked to approve the annual report and future BCF plans before national submission.

National reform requirements

The report explained that following publication of the 10 Year Health Plan for England, the government is reforming the BCF to create a more consistent approach to jointly planned and delivered services. The 2026/27 framework — described as the first stage of reform — requires ICBs and local authorities to plan, agree and assure BCF expenditure jointly, with greater emphasis on demonstrating impact, improving productivity and securing value for money.

Three national funding conditions apply for 2026/27: maintaining a jointly agreed plan demonstrating integrated and preventative care; complying with grant and funding conditions; and maintaining effective joint governance including oversight of expenditure, delivery and performance.

Kent’s BCF assurance return for 2026/27 was jointly agreed by KCC and the ICB and submitted to the National BCF Team on 19 May 2026, receiving approval on 29 June 2026.

Performance targets and risks

The new performance framework will cover four national outcome measures: reducing non-elective hospital admissions for people aged 65 and over; improving discharge performance and reducing delays; reducing long-term admissions of people aged 65 and over into residential and nursing care; and improving reablement outcomes, specifically the proportion of people aged 65 and over discharged into reablement who remain living independently in the community 12 weeks later.

Officers warned that failure to comply with national funding conditions could result in additional regional or national scrutiny, conditions being placed on the use of funding, or escalation through national BCF arrangements. They also noted a risk that some historic schemes may not be able to demonstrate clearly their current contribution to BCF objectives or value for money, and that any reprioritisation of committed funding could affect established services and contractual arrangements.

The council had not published the minutes of the meeting at the time of writing, so the committee’s decision is not yet on the public record.

Sources

Sessions House, County Hall, Maidstone. Picture: Stephen McKay / Geograph, CC BY-SA 2.0