Councils key to driving health and social care integration says report
Author: Localis |
Councils key to driving health and social care integration says report
Think-tank Localis today launches a major new report (link) that explores the fragmentationof the health and social care system, and concludes that empowerment at the local level is key to improving integration.
Two of the report’s key recommendations are for:
The introduction of single, place based commissioning budgets for 40-55 year olds (who gain the most from prevention), and care provision of those over 85 (who are the most likely to have complex medical conditions), in order to eliminate perverse financial incentives and promote integrated care.
Acute trusts being made statutory members of Health and Wellbeing Boards, in order to improve local engagement and leadership, the co-ordination of care and communication between the sectors.
With a foreword from Rt. Hon. Alan Milburn MP, and drawing from a survey of over 100 local authority leaders and extensive interviews with local health experts, the report echoes familiar problems – for example that the health and social care system is still rewarding activity rather than outcomes, and the poor working relationships between the NHS and local government.
But it wasn’t all bad news, withthree quarters of survey respondents saying that Health and Wellbeing Boards (HWBs)had already made a noticeable improvement to health and social care in their local area. And 85% thought that if provided with more powers and responsibilites the HWBs would have an even more substantial positive impact in the future.
The report, ‘Unblocking: Securing a health and social care system that protects older people’, was produced in partnership with older people’s charity Anchor, and will be launched today online.
Support for the report:
Rt. Hon. Alan Milburn MP. “This important report sets out useful proposals to address the problems faced by our health and social care system. It is welcome that the notion of integrating services around the needs of patients and citizens is fast becoming a new orthodoxy in public policy thinking.”
Paul Burstow MP. “This report makes an important contribution to the debate about joined up care. If we are to break the log jam and ensure older people get the right care in the right place at the right time we need three things. We need a long-term funding commitment, we need a single pooled budget and we need a common purpose. Focusing on promoting people’s wellbeing so they can get on with their daily lives should unite the NHS, social care and housing in a shared endeavour”
Launching the report, Localis Chief Executive Alex Thomson said:
“Our research highlights how entrenched the problems caused by lack of integration in our health and social care system are, and the knock-on effects on older people especially. But we do identify some glimmers of hope. In particular, we think that local government has an unparalleled capacity to help drive the necessary coordination between health and social care in order to deliver better care for older people, and others.”
ENDS
Notes to Editors:
For more information, or to arrange an interview please contact:
Archie Maitland, Research Fellow
0207 340 2660 | archie.maitland@localis.org.uk
Our key findings in full:
The health and social care system still rewards activity – not outcomes, so undermining attempts to focus on the successful management of long-term health conditions.
In fact, we financially incentivise disjointed care with short-term budgets that inevitably end up being concentrated on short-term pressures in the system, rather than thinking afresh about how to prevent illness in the first place.
UK healthcare does not do enough to prevent avoidable injuries for older people and is conditioned to keep older people in hospital longer then they need to be there.
Relationships between partners delivering care remain poor.
The Coalition government has acknowledged some of these problems and we have identified some glimmers of hope with positive examples of health and social care working together.
It was revealing, however, that we found many on the ground believing that Westminster and Whitehall do not understand care for older people.
Our key recommendations in full:
To shift the blame away from innocent patients by encouraging the media to stop using the phrase ‘bed blocking’ and instead use ‘preventable bed occupation’.
To better co-ordinate care for the elderly by introducing single, place-based commissioning budgets for 40-55 year olds (who gain the most from prevention) and care provision of those over 85 (who are the most likely to have complex medical conditions). Also the introduction of a Minister for Older People will also ensure that care for the elderly is better coordinated at Whitehall.
To reduce fragmentation of the health and social care system. Firstly by making acute trusts a statutory member of Health and Wellbeing Boards to foster local relationship building, and secondly by fast tracking a best practice accreditor to highlight innovative ideas for integrating health and social care.
To provide budget stability and allow for long-term strategic planning by the next Government committing to a fixed five-year budget. The Government should also review the wider funding mechanisms and set a five-year timetable for complete NHS Tariff review.
To increase the flexibility of primary care by ensuring that technology and innovation are supported and well documented serving as an example for local areas across the country.
About Localis
Localis is an independent think-tank dedicated to issues related to local government and localism. We carry out innovative research, hold a calendar of events and facilitate an ever growing network of members to stimulate and challenge the current orthodoxy of the governance of the UK. Please visit www.localis.org.uk for more information