Decision details

Proposed decision –. Approval of a revised Section 75 legal partnership agreement with Kent and Medway Integrated Care Board.

Reason for the decision

The current Section 75 Agreement underpinning the Better Care Fund (BCF) was established in 2015 and has successfully supported pooled funding arrangements between Kent County Council (KCC) and NHS Kent and Medway. Since then, legislation, national guidance and the scope of integrated working have evolved. Legal advice has confirmed that the agreement should now be updated to ensure it continues to provide an appropriate and robust legal framework for current and future integrated working arrangements.

Updating the agreement will strengthen governance, financial accountability, risk-sharing arrangements and decision-making between KCC and NHS Kent and Medway, ensuring that pooled funding arrangements continue to operate within a clear and robust legal framework.

The revised agreement will also provide the flexibility to support future integrated commissioning and pooled funding arrangements where appropriate, enabling both organisations to respond to national policy developments, including reforms to the Better Care Fund and the Government's ambition to deliver more integrated, neighbourhood-based health and care services.

Approving the revised Section 75 Agreement will provide greater assurance that public funds are managed effectively, roles and responsibilities are clearly defined, risks are appropriately managed and future collaborative arrangements can continue to develop within a robust legal framework

Background

The Better Care Fund (BCF) is a national programme that supports integrated health and social care through pooled funding arrangements between local authorities and the NHS. Each year, the BCF Plan is jointly developed by Kent County Council (KCC) and NHS Kent and Medway, with expenditure approved through the Health and Wellbeing Board.

The current Section 75 Agreement provides the legal framework for these pooled funding arrangements. Although the BCF Plan and financial contributions are reviewed annually, the underlying Section 75 Agreement has not been substantively reviewed since 2015.

Since the agreement was established, legislation, national guidance and best practice have evolved, alongside increasing opportunities for integrated working. Legal advice has confirmed that the agreement should now be updated to reflect these changes and ensure it continues to provide an appropriate legal and governance framework.

Revising the Section 75 Agreement will ensure it reflects current requirements, continues to support the existing Better Care Fund arrangements and provides a flexible legal framework for future integrated commissioning and pooled funding arrangements.

The revision relates solely to the legal framework underpinning the Better Care Fund and does not alter the scope of services currently delivered or the level of funding approved through the annual Better Care Fund planning process.

The revised agreement has been developed using the Department of Health and Social Care's updated national Section 75 template and guidance published in June 2025, ensuring it reflects current national guidance, legal best practice and the requirements of the Better Care Fund Framework.

Options (other options considered but discarded)

Retain the existing Section 75 Agreement without amendment.

The current agreement has successfully supported the operation of the Better Care Fund since 2015. However, it has not been updated to reflect subsequent changes in legislation, national guidance, the Better Care Fund Framework or the increasing scope of integrated working between Kent County Council and NHS Kent and Medway.

Retaining the existing agreement would mean continuing to rely on a legal framework that does not fully reflect current best practice or the evolving policy context. It would also miss the opportunity to strengthen governance, clarify roles and responsibilities, enhance financial accountability and provide greater assurance for future pooled funding and integrated commissioning arrangements.

How the proposed decision supports the Council’s Strategic Statement

The proposed decision supports the priorities set out in Reforming Kent by strengthening partnership working between Kent County Council and NHS Kent and Medway through a robust legal and governance framework for integrated working.

The revised Section 75 Agreement will support the Council's ambition to make the best use of public money by strengthening financial governance, accountability and oversight of pooled funding arrangements. It provides a clear framework for managing financial risk, ensuring public funds are used effectively, transparently and deliver value for money.

The agreement will also provide the flexibility to support future integrated commissioning and pooled funding arrangements, enabling partners to work collaboratively, reduce duplication, maximise the impact of shared investment and improve outcomes for Kent residents.

The proposal aligns with the Better Care Fund Framework 2026–27 and the Government's 10 Year Health Plan for England, which together support integrated working, neighbourhood health services and stronger partnership arrangements between local government and the NHS.

As Cabinet Member for Adult Social Care I agree to:

a)    ENTER into a revised Section 75 Partnership Agreement with the Kent and Medway Integrated Care Board; and

b)    DELEGATE authority to the Corporate Director, Adult Social Care and Health to take relevant actions to finalise the necessary legal agreements and sign the Section 75 Partnership Agreement on behalf of Kent County Council.