Do pooled budgets between the NHS and the Local Authority deliver an opportunity for more creative commissioning resulting in improved outcomes for children so they reach their full potential and live their best lives?


BNSSG ICB Research Capability Funding­­.

What is the research question?

Do pooled budgets between the NHS and the Local Authority result in improved outcomes for children known to Health, Education and Social Care, so they reach their full potential and live their best lives?

What is the problem?

At present, the majority of the Local Authority budget for Looked After Children is spent on a small minority of children with complex and recurring needs. Furthermore, decisions are often made in crisis situations and can involve expensive arrangements, which may occasionally be out of the county. Whilst, these arrangements resolve immediate safeguarding issues, it is not clear if they facilitate the best outcomes for the child. Furthermore, a large amount of time is spent discussing who will pay for the care and interventions. By pooling budgets, the aim of the project is to determine if removing the question of ‘who pays’ focus can better be put on the interests of the child. Additionally, pooling budgets may help to facilitate better options for the child and create solutions to deliver the best care and intervention.

What is the aim of the research?

Evidence is lacking around how outcomes for children may be improved if a joined-up approach to commissioning interventions is employed. Specifically, by pooling budgets to remove the question of “who pays”, can more creative options for care be delivered within the best interests of the child.

How will this be achieved?

The three Local Authorities and the Integrated Care Board will each pool funding together over a period of 12 months.

Each organisation will put forward a handful of cases, with two each as the initial number.  A panel will come together to discuss the children referred and consider support according to local, life-course outcomes and with a best value approach, but without the need to consider options against funding frameworks.

This work will then be evaluated to determine the impact of this approach on this vulnerable group so that consideration can be given to improved commissioning and service designs.

Who is leading the research?

The project is being undertaken by a team from NIHR ARC West led by Professor John Macleod.

Further information

About Professor John Macleod

For more information or to get involved with this project, please contact