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Still no plan for joined-up care, MPs warn in report

Integration needed for health and social care

Jo Carlowe

Friday, 19 October 2018

The government still lacks an effective plan to integrate health and social care, according to the House of Commons Committee of Public Accounts.

In its report: Interface between health and adult social care, published today, the Committee calls on the government to put forward an overall strategy to integrate the health and social care system and alleviate the financial pressures on local authorities.

Despite widespread consensus that integration and joint working is the right way forward for the health and social care system to deliver the best and more effective outcomes for patients, the report notes, there is no overall plan that has been put forward to achieve this.

It states: “Financial pressures and an ageing population have increased the need for joined-up working, with local authorities reducing real terms spending on adult social care by 5.3% between 2010–11 and 2016–17, while the number of people in England aged 85 and over rose by 28% between 2006 and 2016. There are examples across England where integrated working has been successfully applied. But it is a long way from being in place everywhere, with a range of longstanding legal, structural and cultural barriers hindering the pace and scale at which change can happen.”

There has been a lot of discussion within government over how to support and accelerate the integration of health and social care, the report states. It highlights that in the past 20 years alone, there have been 12 white papers, green papers and consultations, and five independent reviews and consultations on the matter.

However, it states: “The government still lacks an effective overall strategy or plan to achieve its long-held aim to integrate these two sectors. The renaming of a government department is a sign of intent but with local authorities squeezed…there is no realistic prospect of progress. Without this progress, people are at risk of not getting the joined-up, co-ordinated care they need, which could lead to poorer outcomes.”

Commenting, Sally Copley, director of policy, campaigns and partnerships at Alzheimer’s Society, said: “Alzheimer’s Society’s Fix Dementia Care campaign has been calling on the government to create a joined-up health and social care system that can deliver high quality care, because time and time again we see people with dementia falling through the cracks.

“Our hospital admissions investigation revealed that last year 50,000 people with dementia were blue-lighted to hospital for avoidable conditions – like infections – due to inadequate care in the community. This is resulting in people getting stuck in hospital, well enough to leave, costing over £3m a week or the equivalent of 36 hospitals a day out of action.

“This is not sustainable. We wholeheartedly support the MPs calling for a joined-up system. The imminent Budget is an opportunity for meaningful investment to put this to rights as, otherwise, integration is a distant pipe-dream for people living with dementia.”

A Department of Health and Social Care spokesperson said: “We are committed to the integration of health, social care and public services, which must work seamlessly together to deliver better quality care, including through the Better Care Fund which is helping people to live independently in their communities for longer.

“We have provided local authorities access to up to £9.6 billion in dedicated social care funding over the last three years and our green paper due later in the year will set out our plans to reform the social care system to make it sustainable for the future.”

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