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Pressure threatens integration and transformation plans

Health and social care leaders call for place-based innovation around individuals’ needs

Louise Prime

Wednesday, 15 June 2016

Better integration of health and social care services, with improved preventative public health focused on individuals and outcomes, is essential if we are to improve care standards, the professions’ leaders said this morning. However, they warned that mounting pressures threaten integration and transformation plans – and in order for them to succeed, national efforts must address the shortfall in funding.

NHS Clinical Commissioners, the NHS Confederation, Local Government Association and Association of Directors of Adult Social Services (ADASS) this morning published a report outlining what they said is 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. In ‘Stepping up to the place [sic]: The key to successful integration’, they identified 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.

They insisted that national leaders must redress the shortfall in funding, particularly in public health and community services as demand outstrips resource; and for local leaders to look beyond individual organisations, to work together to better integrate and make transformation happen more quickly.

They also called for “a cultural shift away from focusing on services only when people are ill or have critical social care needs, and towards improving public health and meeting the needs of people”, and for agreement and action to address those barriers in the way of integration.

NHS Confederation chair Stephen Dorrell commented: “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 report’s authors outlined several principles that they said are required for integration, including:

  • 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

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.”

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