Wandsworth spent every penny of its £56 million NHS integration fund last year and still missed its targets for getting patients home from hospital. The council’s own report admits the money was not enough.
The Better Care Fund is a £56 million pot of NHS and council money meant to keep older people out of hospital and speed up discharge when they are admitted. It was fully spent in 2025-26 with all four income streams coming in at exactly 100% of planned expenditure. Despite that, two of the three national targets were still missed.
The admission is buried in an end-of-year report presented to Wandsworth’s Health and Wellbeing Board (the statutory body that oversees health and social care integration in the borough) at its meeting on 25 June. The paper was listed “for information.” The board was asked only to note the findings, not to take any action in response.
The targets
On emergency admissions of older people to hospital, Wandsworth narrowly missed its annual ambition, though officers note the target was met in six of the 12 months, with a marked improvement in the final months of the year driven partly by a 5.2% reduction in emergency admissions at St George’s.
On discharge delays (the time between a hospital declaring a patient ready to leave and that patient actually leaving) the picture was worse. The target was met in the first quarter, when delays averaged 0.76 days. It was missed in every subsequent quarter: 1.01 days in Q2, 1.12 days in Q3, and 1.02 days in Q4.
One target was met: the rate of permanent admissions of older people to residential care fell within the planned range. The council credits its embedded social work team at St George’s, which operates within the hospital’s discharge hub to maximise the number of patients supported back to their own homes.
The funding gap
The most significant passage in the report is a paragraph by Jeremy DeSouza, the council’s Executive Director of Adult Social Care and Public Health, who wrote that “increased demand has been experienced over and above the funding available through the BCF” and that “the average cost of care home placements has grown above inflation, with no uplift to the LA Better Care Grant to match these rises.”
That is an officer of Wandsworth Council, in a public document, stating that the government grant is structurally insufficient for what care actually costs. The targets existed to measure whether the fund was working. The fund was fully spent. The targets were still missed. And the grant was not uplifted to reflect real costs.
The same report notes that spend ran ahead of plan in areas including home care and short-term residential admissions, “where the demand for services has grown in year.”
What comes next
At the same meeting, Wandsworth’s Health and Wellbeing Board agreed the 2026-27 fund plan. The new allocation is £56.6 million, marginally more than last year. The ambitions are more demanding: the council is targeting discharge delays of 0.79 days in Q1, reducing to 0.65 days by Q4.
Those targets are more ambitious than the 0.76-day benchmark Wandsworth managed to meet only in Q1 of 2025-26 before slipping back. The council’s plan for improvement includes continued data auditing to align hospital and adult social care records and identify where delays are occurring in the system.
If you have been affected
If you or a family member has experienced delays in hospital discharge in Wandsworth, Wandsworth Council’s Adult Social Care team can be contacted via an online enquiry form (Monday to Friday, 9am to 5pm). Those who cannot use the online form can call 020 8871 7707. Outside office hours, the Out of Hours team is available on 020 8871 8999. Patients discharged from St George’s Hospital can raise concerns with the hospital’s Patient Advice and Liaison Service (PALS) by calling 020 8725 2453 or emailing pals@stgeorges.nhs.uk (Monday to Friday, excluding bank holidays).
