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27.10.16

Better care integration could stop a quarter of hospital admissions, LGA says

Better integration of health and social care could prevent over a quarter of hospital admissions, the LGA said today.

The LGA commissioned consultants Newton Europe to conduct a review of health and social care in five areas (Kent, Pennine Lancashire, Greenwich, Swindon and Sunderland), which found that 26% of hospital admissions had missed opportunities for other forms of care that would have prevented the need for an admission.

It also found that better integration of care would have saved 7-10% of the areas’ budgets, saving over £1bn nationally.

Cllr Izzi Seccombe, chair of the LGA community wellbeing board, said: “Our analysis shows the sheer scale of the funding crisis we face in social care, both now and in the near future, as well as the damage done from the historic underfunding of adult social care.

“Councils, care providers, charities and the NHS are all united around the need for central government to fully fund adult social care. This is essential if we are to move away from just trying to keep people alive to ensuring they can live independent, fulfilling lives, as well as alleviating the pressure on the NHS.

“The care provider market cannot carry on as it is and there is a real danger of more widespread market failure. Either care is properly funded or providers will pull out of council contracts or in worst case scenarios go bust. The market for publicly-funded care is simply not sustainable as it stands.”

She noted that the reforms recommended in the report should be achieved by transferring funding from acute care to community and social care, for instance through CCGs’ administration of the Better Care Fund.

The LGA is also lobbying for the government to bring forward the £700m fund from the end of the decade to this year, although the Department of Health has refused to do so for 2016-17.

The report said that preventative services should focus on hospital discharges. For 24% of discharged patients, researchers identified an alternative care plan that would have saved money. Long-term residential placements were particularly costly.

It recommended better investment in preventative services, saying that 25-40% of service users did not receive preventative care and would have benefited from it.

According to the report, local authority staff also had no consistent strategy for making care decisions, and there was “over-provision of care” in almost all cases, reducing service users’ independence.

The report’s authors said they had found that successful authorities had a number of strategies for health and social care provision.

These included focusing efforts where the biggest difference could be made, strong leadership, aligning strategies between health and social care systems and involving frontline staff in decisions.

A Department of Health spokesperson said: “Patients should never be in hospital unnecessarily and we are determined to make health and social care more integrated so they get relevant, high quality care in hospital and community settings. That’s why we have given local authorities access to up to £3.5 billion to spend on social care and we will be investing an extra £10 billion a year so the NHS can introduce its own plan for the future.”

“NICE has guidelines for better coordination between health and social care, and we are working with NHS England, NHS Improvement and local government on wide-ranging support to improve quality and efficiency.”

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