NHS Confederation and LGA warn integration and transformation plans are at risk

16 Jun 2016 10:41 AM

Health and social care bodies warn integration and transformation plans are at risk amidst mounting pressures

Leaders from across the health and social care sector are calling for an end to the status quo and for place-based innovation and transformation to happen on a scale and pace not yet seen. 

Stepping up to the place: The key to successful integration, a report released yesterday by the NHS Confederation, Local Government Association, Association of Directors of Adult Social Services (ADASS) and NHS Clinical Commissioners outlines the first whole system vision for integration based on forming care around the needs of individuals in a society with increasingly chronic and complex health needs.

The report also identifies challenges, including an unprecedented pressure on funding that have put plans to improve patient care, and the sustainability of the whole health and social care sector at risk. 

In order to integrate services faster, the report calls for: 

• National leaders to redress the short-fall in funding, particularly in public health and community services as demand outstrips resource  
• A cultural shift away from focusing on services only when people are ill or have critical social care needs, to improving public health and meeting the needs of people
• Local leaders to look beyond individual organisations to work together to better integrate and make transformation happen quicker 
• Agreement and action to address the barriers to making integration happen  Stephen Dorrell, Chair, NHS Confederation said: ​

“This report sends a clear message that to improve the standard of care that we deliver to people we must better integrate our health and social care services. The NHS continues to face unprecedented demand and challenging financial circumstances. Against this background, we need to make sure we are utilising all the collective resources of a ‘place’ to benefit our local communities. There is now a real urgency to deliver on this ambition. Our priority now must be to turn rhetoric into action.” 

The principles required for integration outlined in the report include: 

• A shared commitment to prevention, redirecting investment across health and care services to prioritise public health and community services
• A focus on keeping people well rather than waiting to treat ill health  
• Alignment of workforce planning across local government and the NHS to better meet the needs of local communities
• Designing services around the individual and their outcomes, involving people in decisions based on what is important to them
• Locally appropriate and accountable governance arrangements – allowing leaders to be held accountable locally 
• Shared systems including jointly identifying and sharing risk

The Local Government Association’s Community Wellbeing spokeswoman, Cllr Izzi Seccombe, said:

“Health and social care faces major financial and demographic challenges meaning we have to change our model of support. We believe a shared local vision based on local populations’ health needs, and developed with local leaders is the most effective way of using public resources to improve health and wellbeing.

“The central purpose of integration is to meet the needs of communities, achieve the best possible health and wellbeing outcomes for residents, enable them to keep well, remain independent and allow them to contribute to the prosperity of their local areas.

“Political leadership and democratic accountability will be crucial in ensuring that integration plans are focused on getting better health outcomes, improving services and addressing the financial challenges.”

Dr Amanda Doyle and Dr Graham Jackson, Co-chairs of NHS Clinical Commissioners, said:

“We are very pleased to have developed and shaped this vision with our partners across the system, who like our member CCGs, recognise that the integration of health and social care is key to delivering truly person-centred care and that we must focus on the concept of place-based commissioning. 

“Fulfilling the vision we’ve collectively set out here at a local level is also critical if we are to achieve our shared ambitions of transforming care and delivering better outcomes for our populations.”

Harold Bodmer, President of the Association of Directors of Adult Social Services (ADASS), said:

“Integration is an important step towards transforming services for adult social care so they are sustainable for the future, but cannot be seen as an end in itself. It is a means to improving outcomes and the experience local communities

• Designing services around the individual and their outcomes, involving people in decisions based on what is important to them 
• Locally appropriate and accountable governance arrangements – allowing leaders to be held accountable locally 
• Shared systems including jointly identifying and sharing risk

The report outlines a number of health and social care services that have made significant progress to integrate and transform care. While there are excellent examples, more needs to be done at a national level to provide support, guidance and investment in the vision so that all local leaders across the country can work to make transformation happen at a faster rate.