The effects of the Better Care Fund on healthcare utilisation and well-being among patients and older adults in England

Integrated care models have been widely adopted as a strategic response to the increasing health and social care demands associated with an ageing population. Pooled funding has been a promising solution to overcome the fragmentation between health and social care sectors, yet its impact remains underexplored. This study examines the effects of England’s Better Care Fund (BCF) – a nationwide initiative mandating pooled budgets between health and social care – on healthcare utilisation and well-being among patients and older adults (65+). Using local authority-level data between 2013 and 2019 (n = 1,001), we employed fixed effects models and multiple sensitivity analyses to evaluate the effectiveness of the BCF. The findings indicate that higher BCF expenditure significantly reduced delayed transfers (DTOC) and depression rates, with these effects most evident over an extended follow-up period. However, BCF expenditure had non-significant impact on other generalised outcomes such as emergency admissions, institutional care admission rates and social care-related quality of life (SCRQoL) among older adults. These results highlight the importance of long-term follow-up in evaluating pooled budgets, demonstrating the effectiveness of the BCF in terms of more specific policy objectives like reducing DTOC. These insights could guide policymakers to optimise integrated care systems.