What we looked at 

In 2019, we published a Review of the Integrated Care Fund. The Welsh Government set up the Integrated Care Fund (ICF) in 2014 to enable regional partnerships to better integrate health, social care, and housing.

The review described the ICF’s positive impact on improving integration and partnership working. However, it also identified weaknesses in the way the annual fund was managed. It made six recommendations for the Welsh Government which it accepted in full. 

In April 2022, the Welsh Government replaced the ICF along with its Transformation Fund with the Health and Social Care Regional Integration Fund (RIF). The capital elements were replaced with a new Housing with Care Fund. 

This report examines the extent to which the Welsh Government has implemented our recommendations through the rollout of the RIF, and to a lesser extent through the Housing with Care Fund. 

Why this is important 

The RIF is a key part of the Welsh Government’s approach to achieving its long-term vision of integrated health and social care, set out in its 2018 strategy, A Healthier Wales. Through the RIF and Housing with Care Fund, along with the Integration and Rebalancing Capital Fund it aims to embed a preventative approach to population health and wellbeing, and delivery of seamless health and care support. 

The RIF is the Welsh Government’s main funding to support early intervention, integration, and partnership working through Regional Partnership Boards (RPBs). It is a five-year fund running from April 2022 to March 2027, with an annual budget of around £146 million. 

What we have found 

The Welsh Government’s Regional Integration Fund is supporting regional working and developing seamless models of care. Now in its fourth year, the fund has had a positive impact on many people’s lives. In 2024-25, it supported over 180,000 people to prevent their health and care needs escalating. 

The Welsh Government has fully implemented five of our six previous recommendations and partly completed the remaining one. It has improved the timeliness of its decision-making and monitoring information, strengthened its oversight and supported RPBs to share learning. However, we found some minor gaps in the Welsh Government’s oversight of RPB spending of the RIF. We also found that some shared learning networks are more effective than others.

Despite the Welsh Government’s efforts to simplify RPB funding arrangements, those arrangements are still complex and could be better integrated. There are also concerns about longer-term funding to replace the RIF programme in 2027, particularly as RIF funding is being used to fund some services which are now embedded in the health and social care system.

We identified weaknesses in oversight by statutory organisations of RPB activities and how RIF funding is being used. Health boards and local authorities are responsible for ensuring appropriate oversight takes place. The Welsh Government could also do more to assure itself that those bodies comply with its guidance on oversight. 

What we recommend 

We are reissuing two of our previous recommendations, updated to reflect the current delivery context. These focus on further simplifying and aligning RPB funding streams and ensuring appropriate scrutiny of RPB decisions in the regional statutory organisations. 

We are also making two new recommendations to improve the quality of the Welsh Government’s oversight of RPB spending.