Latest Public Sector News

29.05.19

Integration? Get these two things right first

Dr Charlotte Augst, chief executive of National Voices, a coalition of charities that stands for people being in control of their health and care, details how the integration between health and social care can be made more easily and effectively for the future.

The NHS Long-Term Plan is the last iteration of a long-standing but elusive commitment to better integration of health and social care. It is filled with ambitions: regional integrated care systems are expected to make the NHS work hand-in-hand with local authority-funded services; new primary care networks are supposed to join teams at a local level; a place-based, population health approach is set to help understand the areas that have the greatest need.

The fact that the long-awaited social care Green Paper was left behind by the NHS planning frenzy doesn’t fill us with confidence that the top tier of government is fully sold on the need to think about both as part of the same system.

There are huge frustrations for the many people who need services from both the health and care system, such as people living with the impact of stroke, dementia, arthritis or mental ill health, or people at the end of their lives. Hollowed-out social care also impacts on people who might only be sporadic users of the NHS, such as people whose operation has been cancelled because of a shortage of beds, or people who can’t access timely emergency care because hospital wards are full.

So, against these financial and structural odds, what do we hope can be achieved by the latest push for integration as outlined in the long-term plan?

In our view, what might make a significant difference is that the plan demands a shift to a ‘new service model’ with care based close to home, and is accompanied by a comprehensive approach to Universal Personalised Care. This rightly focuses on people and how their experience of using NHS services needs to change.

It contains very welcome and substantial commitments on shared decision making, good care and support planning, and access to non-clinical support that helps people achieve their ‘self-management’ goals. These programmes will force the issue of integration up the agenda.

We believe there are two important things to get right:

Care planning: Done well, it is the true enabler of integration because services all need to end up in one plan. This will require tackling the cultural and behavioural obstacles that get in the way of good holistic decision making. It won’t work to draw up a plan that focuses on clinical care but doesn’t address someone’s needs for personal care, emotional support, or help to rebuild social connections.

Social prescribing: This brings together formal statutory services and the myriad of possible support offers based in the community and voluntary sector, joined through link worker or community connector schemes. The substantial commitment in the plan is based on the welcome realisation that people with health problems often also have non-medical needs, and that communities have a big role in helping people live as well as possible for as long as possible. What is clearly not going to work is if the NHS simply throws people and their needs over the fence into local authority or voluntary sector support – community approaches are good value, but they are not free.

Any efforts to integrate services by linking healthcare and social or community support in this way will fail if they don’t acknowledge the massive pressures local authority budgets have been placed under, and the cuts to preventive community provision those have entailed. Social prescribing can’t just be ‘referrals’, it needs a commissioning plan behind it.

At National Voices, we are working towards person-centred care: people having as much control and influence over their care as possible – as patients, carers, and members of communities. We will continue to work with NHS England, commissioners, providers, health professionals, and the voluntary and community sector to make a real difference to people’s experience of using health and care services.

Comments

There are no comments. Why not be the first?

Add your comment

 

related

public sector executive tv

more videos >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the open more > more last word articles >

public sector focus

View all News

comment

A fifth of public sector workers have never received a thank you from the people they serve

13/06/2019A fifth of public sector workers have never received a thank you from the people they serve

A fifth of the country’s public sector workers say they have NEVER re... more >
Time to build a truly northern powerhouse

11/06/2019Time to build a truly northern powerhouse

Jack Hunter, a research fellow at think tank IPPR North, discusses how to u... more >

interviews

Artificial intelligence: the devil is in the data

17/12/2018Artificial intelligence: the devil is in the data

It’s no secret that the public sector and its service providers need ... more >

the raven's daily blog

New rules to change the future of Social Value

05/06/2019New rules to change the future of Social Value

The government has announced the introduction of new rules to change the future of social value and make the way housing developers stump up the money for infrastructure both ... more >
read more blog posts from 'the raven' >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this feeling of imminent change than the article James Palmer, mayor of Cambridgeshire and Peterborough, has penned for us on p28. In it, he highlights... read more >