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Independents' Day

NHS to be fully integrated with social care 'by 2018'

The health and social care system in England will be fully joined together by 2018, with CCGs urged to put aside 2% of their funding each year to encourage more integrated care, the Goverment has pledged.

The bold plans aim to prevent patients ‘falling through the cracks’, with new ‘pioneer’ areas around the country - to be announced in September - to trial more integrated care for patients with local providers, including GPs.

The national ‘shared commitment’ to integrating care, will be unveiled by health and care minister Norman Lamb today, with ten ways that each NHS organisation will work towards joining up their services with other local services.

The plans come despite an official evaluation of 16 Department of Health pilots looking at more integrated care published last year concluding they had a broadly negative effect on patient satisfaction and did not deliver any tangible cost savings.

A DH statement said: ‘The document lays 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.’

The plans aim to ensure patients do not have to re-tell their history every time they encounter a new service, and will improve communication between services, health and care workers making home visits at different times, unnecessary A&E admissions and delayed discharges from hospitals.

The DH added that it wants CCGs to consider setting aside 2% of their funds for ‘non-recurrent expenditure’ on integrating services. The statement said: ‘We encourage [CCGs] to consider using this to support innovative approaches to integrated care and support.’

In announcing the policy, Mr Lamb commented: ‘People don’t want health care or social care, they just want the best care. This is a vital step in creating a truly joined up system that puts people first.’

‘Unless we change the way we work, the NHS and care system is heading for a crisis. This national commitment to working together is an important moment in ensuring we have a system which is fit for the future.’

The DH said it was inviting expressions of interest for pioneer sites to be submitted by the end of June, with the sites to be confirmed in September. The pioneers will be ‘helped’ by a central Integrated Care and Support Exchange (ICASE) team which is being put in place and ‘in return’ they are expected to share their experiences with the rest of the country, said the DH.

But health thinktank the Nuffield Trust warned that many plans to better integrate care in the NHS had fallen by the wayside.

Nuffield Trust executive Dr Jennifer Dixon said: ‘There have been attempts 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. It will be important to learn carefully from new initiatives and not over claim their benefits.’

Click here to view the Government’s letter of invitation to local areas

Readers' comments (5)

  • So after pledging no top down management, the CCGs are being "encouraged" to put aside 2% for their new idea?

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  • The fundamental problem here is "competition". If you arrange things so that individual providers compete for contracts, they are not minded to co-operate with each other.
    In our area we have consultants who are not allowed to speak to GPs unless the trust is paid an item of service fee and community nurses who were told by their trust not to speak to GPs because we were their commissioners and GPs were not to know anything about the way they worked.
    We also have absolutely no evidence that community matrons reduce hospital admissions and my experience is that, for the best of reasons, they panic and send people into hospital when a GP might not. I have asked our PCT on several occasions for an evaluation which shows a reduction in hospital admissions and they have been totally unable or unwilling to provide it. The same inability to evaluate and manage risk applies to 111 and others such as carers and physios and enormous numbers of people are being sent to AE unnecessarily.
    The only way out of this mess is to provide enough GPs to manage the system and the risk appropriately and patient education about what is and what is not reasonable along side support staff such as physios care assistants and nurses when needed.
    The pretence that careers, social services and nurses can prevent admissions without GP support has been destructive and damaging.

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  • I agree with the above. Our PCT/CCG has shown that Community Matrons do not reduce admissions, but equally dont increase them. The CMs role seems to be bashing at the doors of understaffed/underfunded SS and other community services to get community care.

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  • This is a covert way for so-called ring-fenced NHS funds to be sidled off into Social Services.
    Do not trust politicians who are cock-a-hoop they have got GPs to hold the purse-strings.

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  • I'm getting déjà vu ... Seamless service, that was the goal back in the 90's. Practice based community teams, practice based social services link worker ... All subsequently stripped away by PCG.

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