What are the implications for the Better Care Plan?

Carer and elderly manFrequently Asked Questions.


What are the ambitions for the better care plan?

Our shared ambition is to reduce the average length of stay of emergency admissions by 20% (approximately two days) over the next two years. This will be achieved by improving the flow through the acute hospitals by enhancing the services on the front of the emergency system as well improving the discharge process.

We are also expecting to see a reduction in non-elective admissions of 4.5% in 2014/15 and for 2015/16 commissioners are setting an ambition of minimising the impact of demographic growth which equates to approximately 2%. This will be achieved by reducing the level of inappropriate admissions through the enhancement of health and social care services to support people more effectively in the community. This will include the enhanced community response to supporting clients in crisis situations.

The CCG and council have modelled the potential impact of the Better Care Plan on the three trusts for 2014/15 and have set an ambition of reducing the demand on acute bed capacity by 20%. For patients who stay longer than two days this will equate to approximately 37,000 bed days by reducing the average length of stay by two days. Table 5 represents the potential impact across the three acute hospitals.


What is the impact of not delivering our Better Care Plan objectives?

We will work in partnership with the acute hospitals to reduce length of stay and the non-elective admission reductions will have a number of effects. We know that the result of not doing this would be as follows:

  • Hospitals would struggle to expand their current bed capacity as growth of 3.3% or more would impact on the acute system in 2014/15 and 2015/16. The predicted extra number of required beds could be as many as 15 beds per year across the three acute hospitals.
  • The CCG would experience ‘over performance’ on the three acute hospital contracts as non-elective QIPP targets would not be deliverable. The financial impact of non-delivery of the Better Care Plan objectives in relation to length of stay and reduced admissions is £3m for the CCG in 2014/15. The impact would approximately double in 2015/16 if growth could not be contained and the Better Care Plan and other initiatives did not deliver. The CCG will have only limited reserves to mitigate this over performance in 2014/15 and 2015/16 due to the creation of the Better Care Fund.


The result of longer stays in hospital will mean there will be a rise in care home admissions. The Better Care Fund includes a growth prediction of £1.8m over and above the Wiltshire Council funded growth. If the objectives of the Better Care Plan are not delivered, then the £1.8m will be required for care home placements, and will have a recurrent impact in 2015/16.

If you would like to know more about the plan then click to go to the Better care plan. If you wish to go back to the plan's home page please click here.