Better Care Fund Series 1 — Article 2 of 3

VCSE Commissioning Analytics Series — Article 6 of 18 | Better Care Fund Series 1 — Article 2 of 3

BCF Metric 1: Non-Elective Hospital Admissions for People Aged 65 and Over | Better Care Fund Series 1 — Article 2 of 3

Better Care Fund metrics are the headline performance indicators against which local authorities and integrated care boards demonstrate the impact of pooled health and social care investment. The BCF framework specifies three headline metrics that local Health and Wellbeing Boards must set local goals against. For VCSE organisations whose services sit within the BCF commissioning landscape, these three metrics define the outcomes evidence that matters most in commissioner conversations, contract reviews, and neighbourhood health plan development.

The first headline BCF metric measures unplanned hospital admissions for older adults. Local areas set goals to reduce this rate over the BCF planning period. VCSEs whose services directly affect this metric include those delivering falls prevention programmes — falls in older adults are one of the leading causes of emergency hospital admission in England, with NHS England data showing that falls account for over two million A&E attendances per year. VCSEs delivering community frailty support, mental health crisis prevention for older adults, and social prescribing programmes also affect this metric.

The evidence VCSEs need to produce includes: the number of falls or crisis events prevented in their service user cohort; comparison of A&E attendance and non-elective admission rates for their service users before and after intervention; and population benchmark comparisons showing whether their service users have lower admission rates than equivalent non-service populations.

BCF Metric 2: Delayed Discharges from Hospital

The second headline BCF metric measures delayed discharges from acute hospital care. It has two components: the number of patients not discharged on their Discharge Ready Date, and the average number of days from DRD to actual discharge for those who were delayed.

VCSEs whose services directly affect this metric include those delivering step-down care and intermediate care services; reablement services that enable people to return home with support after hospital admission; housing support and adaptation services that remove housing barriers to discharge; and community nursing or allied health support that provides an alternative care pathway to extended acute hospital stay.

The evidence VCSEs need to produce includes: the number of service users received from acute hospital on a pathway linked to discharge; the mean time from referral to first service contact; the proportion of people who achieved a defined independence outcome within a specified timeframe; and the proportion who avoided re-admission within 30 days of discharge. Thirty-day re-admission rate is a particularly powerful metric for VCSEs in discharge support — a VCSE that can demonstrate a lower re-admission rate for its service users than the hospital overall baseline is making a compelling, quantifiable contribution to the BCF metric it affects.

BCF Metric 3: Long-Term Admissions to Residential Care Homes

The third headline BCF metric measures the rate of long-term admissions to residential care homes and nursing homes for people aged 65 and over, expressed per 100,000 population. VCSEs whose services affect this metric include those delivering intensive community support for older adults and people with dementia; carers support services that sustain informal care arrangements; independent living support; and community mental health and wellbeing services that prevent deterioration.

The evidence VCSEs need to produce includes: independence outcome scores for service users at baseline and at follow-up intervals; proportion of service users who remained living independently in the community at six and twelve months; carer resilience outcomes; and where data partnerships allow, comparison of residential care admission rates for VCSE service users against population benchmarks.

Connecting VCSE Service Data to BCF Goal-Setting

Health and Wellbeing Boards set local goals against all three BCF headline metrics annually. The most effective approach for VCSEs is to apply VCSE commissioning analytics to understand the specific local goals set by their HWB and structure their outcomes reporting around the evidence needed to demonstrate contribution to those goals. This requires a VCSE to know which BCF metric its service affects, what the local goal is for that metric, and what data it needs to collect to demonstrate a credible directional contribution.

According to the BCF 2026 to 2027 framework published on gov.uk, strong governance arrangements must be in place to monitor efficiency, effectiveness, resource allocation and improvement — and VCSE data is part of that evidence base.

Frequently Asked Questions

What are the three headline Better Care Fund metrics?

The three headline BCF metrics are: non-elective hospital admissions for people aged 65 and over; delayed discharges from hospital measured against Discharge Ready Dates; and long-term admissions to residential care homes for people aged 65 and over per 100,000 population.

Which VCSE services affect the non-elective admissions BCF metric?

VCSEs delivering falls prevention, community frailty support, mental health crisis prevention, and social prescribing programmes affect the non-elective admissions metric by reducing the circumstances that lead to emergency hospital admission for older adults.

What evidence does a VCSE need to demonstrate contribution to the delayed discharge metric?

VCSEs need to show: number of people received from acute hospital on a discharge pathway, response time from referral to first contact, proportion achieving independence outcomes within a specified timeframe, and 30-day re-admission rates for their service user cohort compared to hospital baseline figures.

How do VCSEs use BCF metric goals in commissioning conversations?

The most effective approach is to ask the commissioning local authority what the Health and Wellbeing Board specific goals are for the BCF metrics relevant to the VCSE service type, then structure outcomes reporting to show a directional contribution to those specific goals rather than generic outcome data.

What data infrastructure do VCSEs need to produce BCF metrics evidence?

VCSEs need longitudinal individual service user tracking, outcome measurement at multiple timepoints, response time recording from referral to first contact, and where available through local data partnerships, access to population health benchmark data to contextualise outcomes.

To discuss how Quematics builds Better Care Fund analytics and metrics evidence infrastructure for VCSE organisations, visit our data analytics for charities page or contact us for a free 30-minute data review.