Plans to make joined up health and social care the norm by 2018 have been announced by the government.
The aim is to put an end to people being “passed round the system” and “falling through the cracks” of uncoordinated care.
Better integrated care between hospital and social care staff could relieve pressure on A&E services by preventing emergency readmissions and could also help to reduce the £370 million a year cost of long waits for discharge from hospital. It should also ensure that people get the support they need with the appropriate information and notes being shared by different parts of the system, argues the government.
“Unless we change the way we work the NHS and care system is heading for a crisis,” said care and support minister Norman Lamb.
The government has set out plans for pilot areas from September to pioneer the practical approaches that are needed to achieve change as quickly as possible.
New measures of people’s experience of joined up care and support will be introduced by the end of this year to monitor whether people are feeling the benefits of the change.
The government has also published a Shared Commitment document which sets out how the national leaders of the health and care system have come together to help local areas make integration happen.
It sets out how local areas should use existing structures like Health and Wellbeing Boards to bring together local authorities, the NHS, social care providers, education, housing services, public health and others to bring about better integration of local services.
But the government has not committed any additional money to the proposals. Instead it is suggesting that clinical commissioning groups should set aside two per cent of their annual funding for non-recurrent expenditure to support innovative approaches to integrated care.
Michelle Mitchell, director general of Age UK , said that for the government’s vision for integrated care to become a reality, there needed to be good social care provision in place with sufficient funding. Since the government came to power, £710 million in real terms had been cut from social care budgets mostly through reduced local authority funding. She called for an emergency injection of funds to “shore up the current system”.
Chris Ham, chief executive of The King’s Fund, warned that feedback from their work with local health and social care leaders indicated that some aspects of current policy and regulation were acting as barriers to delivering co-ordinated care. “This should be addressed by giving pioneer areas freedoms and flexibilities to overcome these restrictions when they are rolled out from September,” he said.
Nuffield Trust chief executive Dr Jennifer Dixon also cautioned that it would be important to learn carefully from new initiatives and not over claim their benefits. “There have been attempts to develop integrated care for at least 20 years, but with mixed results. The will is there but the policy context can often work against hard won efforts. Today’s announcement recognises this by attempting to align a number of policies to speed progress,” she said.
Professor Andrew Kerslake, associate director of the Institute of Public Care, said: “Health and social services can be integrated managerially but the important question is are services integrated at the point of delivery – in other words does the person in the community experience an integrated service that could prevent them from being admitted to hospital?
“People want to experience integrated care because they don’t want to be constantly referred from one service to another and that’s something the government is hoping to achieve but integrated care on its own won’t deliver what NHS and social care needs which is a reduction in demand.
“Also I worry that integration actually hides issues around performance because studies by the Royal College of Physicians have shown that the health service is simply not performing well enough on some of the areas concerning older people such as dementia, falls, strokes, continence etc. Integration will help but it is not necessarily the solution.”
Professor Andrew Kerslake is speaking at www.healthpluscare.co.uk on 12 June. Visit the website to register for a free ticket.