Is the future of health and social care integrated?

Rhiannon Evans-Young

For some time now, integration has been a buzz word in the Health and Social Care sector.

The Government sees integrating NHS and social care budgets as the silver bullet which will alleviate the pressures that both the NHS and Local Authorities are straining under. The aim of integration is to give Local Authorities greater funding to provide social care and support services that keep people healthier for longer, by anticipating their needs, and providing the right care for each individual. This in turn would take pressure off the NHS by reducing the number of non-essential hospital admissions, and alleviate the chronic problem of bed-blocking.

This significant step-change in social care was to be funded by the £3.8bn ‘Better Care Fund’. Nearly £2bn of this pot was to come from NHS budgets, with the promise of long-term savings being delivered to off-set this. However, it was revealed this month that a Cabinet Office review of the Better Care Fund found the proposed savings it would bring to the NHS remain poorly evidenced. These revelations have seen the launch of the programme delayed.

A question mark remains as to how the scheme will now progress. Whether it is a question of greater funding or better research, a huge amount hangs on the introduction of integrated healthcare, not only politically but for the providers, commissioners and service users involved.

The Better Care Fund had already come in for scrutiny. Shortly before the Care Bill passed its Third Reading in the House in March, leaders from the Health and Social Care sector penned an open letter to the Telegraph. They claimed the Better Care Fund (some of which was earmarked to help Local Authorities implement the Care Bill’s widespread reforms) was woefully underfunded to successfully deliver such a mammoth task. Leading figures from groups such as the Local Government Association and ADASS claimed a minimum of £135 million more was needed to help councils implement social care reform, given massive recent budget cuts. So what does the future of integrated care look like now that the supposed panacea for change has taken such a battering?

Both the Tories and Labour see integrated care as a major part of their healthcare policies. The odds are on for it to appear in both their manifestos, and so this set-back is unlikely to put paid to the idea for very long. Given squeezed Local Authority budgets and an ageing population – both of which are putting increasing pressure on the NHS – pooling certain funds between Local Authorities and the NHS seems like the only way to shake up and improve a cash-strapped system where cracks are starting to show. Streamlining services to provide better, more efficient care while removing unnecessary pressures on the NHS is, in theory, an innovative policy which the nation badly needs. However, the question remains as to whether the money and infrastructure exists to make this happen successfully, and soon.

Many think the fund isn’t big enough to help councils cope with the change. Others see the NHS as already stretched to breaking point; a further £1.9bn lost from its books potentially pushing it over the “financial cliff edge” described by NHS England’s former Chief Executive Sir David Nicholson last year.

The pressure is on the current Government to move past this negative review and get the integrated healthcare plan firmly back on its feet. For a policy with such wide-ranging repercussions and one where the stakes are so very high, the politicians and policy makers must work hard to keep an innovative reform on track, and on budget.

This article was first featured in the May print edition of Healthcare Business News

Rhiannon Evans-Young is a PLMR Account Executive, working on lobbying and media campaigns for a variety of clients across the health & social care, legal and charity sectors.

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