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Social care is not the NHS’s ugly sister

GPs and commissioners could help make integrated care a reality, writes Paul Burstow MP, and the Department of Health has promised cash to make this happen

For more than 60 years, social care has been overshadowed by its more glamorous sister, the NHS. Where the NHS is universal, comprehensive and adored, social care is often confusing, disjointed and unloved – little more than a safety net. It is time for this to change. And one of the biggest shifts must be about integration.

We all know the stories of people bombarded by the same questions, endlessly bounced from pillar to post. How much better would it be if people could just get on with their lives and their care without having to continuously jump through hoops to do so?

The Care and Support white paper sets out how we will integrate health, care and support services. The NHS Future Forum said the focus should be on the person, not just the condition or the organisations involved. I absolutely agree. I want to support providers and commissioners to make this a reality, to give professionals, like GPs, the freedom to join up services in their communities.

By bringing together leaders of CCGs, local councils, patient representatives through local Healthwatch, public health and children's and adult social services, health and wellbeing boards are ideally placed to start this process. In terms of real change on the ground, they are in the driving seat. 

But in the words of John Wilderspin, the national director for health and wellbeing board implementation, change can only happen when all those involved ‘share a set of common goals and empower their staff to work together around the interests of the individual patient or user'. In other words, it requires collaborative behaviour to become the norm.

To help you on your way, two papers on integration will be published next month. The first draws on the experience of emerging health and wellbeing boards. It will encourage them to ask the big questions, such as: how do we innovate? How do we integrate? How do we pull together for the good of our community? It will encourage an open conversation, leading to a common understanding and agreement on the way forward. 

The second paper, developed by the NHS Confederation, the RCGP and ADASS, will offer practical advice to help health and wellbeing boards and CCGs to commission integrated care between primary, community and social care. 

In addition to this, we are working with partners across the new health and care system on how we take integration further. These include: looking at better ways to measure and understand people's experience of integrated care; the development of contracts covering all health and social care needs for older people; and consulting on a new pledge in the NHS Constitution on care co-ordination for people with complex needs and long-term health conditions.

To help integration happen, we will back our words with money. An extra £100m in 2013/14 and £200m in 2014/15 will be transferred from the NHS to social care, specifically earmarked to improve integration. That's on top of the £7.2bn announced in the Government's last spending review.

This new money will help fuel innovation across areas such as healthcare, housing, education, leisure and transport, as well as traditional care and support services.

Many emerging CCGs I've spoken with are excited by the potential of working with their local council, often for the first time, to improve the wellbeing of their patients. But there is no one-size-fits-all solution. Every area will be different.

I would encourage all CCGs to work closely with their local council. The NHS Commissioning Board will support them, helping CCGs to improve how they share information, pooling funds and working across professional, organisational and cultural boundaries.

The new Staffordshire and Stoke-on-Trent Partnership NHS Trust is a great example of what is possible. An NHS organisation, it is now responsible for adult social and community healthcare across Staffordshire. Almost 1,000 social care staff and £153m is being transferred from the council to the new trust to give people faster, better, more integrated care designed around them as individuals.

We need to see care and support not as the ugly sister, but as every bit the equal of the NHS. We need to integrate services to serve the individual needs of patients and care users. And we need GPs to be at the forefront of this at every step of the way.

Paul Burstow MP is the minister for care services

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