Plans to save money by merging health and social care have been blasted as 'a shambles' after it was revealed they have delivered less than a third of the £1bn originally estimated.
Chair of the Public Accounts Committee, Margaret Hodge, said she was 'dismayed' by delays and changes to the Better Care Fund, which had weakened its credibility with local bodies.
The fund, set to be launched next April, aims to deliver more joined-up local services to older and disabled people to care for them in the community.
Although the Government said it would save the NHS £1bn in 2015-16, current plans forecast just £314m of savings.
The Government paused and redesigned the scheme in April when they realised it would not meet their expectations.
Amyas Morse, head of the National Audit Office, said: 'The Better Care Fund is an innovative idea but the quality of early preparation and planning did not match the scale of the ambition.
'The £1bn financial savings assumption was ignored, the early programme management was inadequate, and the changes to the programme design undermined the timely delivery of local plans and local government's confidence in the fund's value.'
He said government departments should give more effective support to local areas, improve joint working between health bodies and local government, and provide better evidence on effectiveness.
Ms Hodge said: 'Successful delivery depends on goodwill and joint commitment but delays and changes to the fund’s design have weakened its credibility with local bodies and lost goodwill.
'It is deeply disturbing that local government believes the changes to targets and how the fund will be run move the integration agenda backward and not forward.'
She added: 'The Better Care Fund is a complex and challenging initiative that clearly requires strong leadership and effective cross government working, both of which have been lacking.
'It is hard to believe that until recently there was no central management team or programme director and there were only limited attempts to identify and manage risks to successful delivery.
'Such incompetence from departments is unacceptable at a time when the number of people most likely to need care is rising, and overall funding is falling.'
She said her committee would 'robustly question' officials on plans for the fund next month.