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London Councils urged to develop ‘full narrative’ for health and social care integration

Devolution of health powers could be the key to improving care outcomes for London authorities, but councils must do more to present and explain local integration initiatives to the capital’s population, a new report has revealed.

The London Councils report, detailing how devolution could be used as an enabler for driving health and social care integration, said that councils would benefit from a “full narrative” that would set out how integration could be used to drive health and social care reform for the public.

It added that subject to the health devolution MoU with national partners being agreed, the roll-out of “devolution as an enabler of deep and successful integration and reform will require strong political leadership underpinned by a coherent narrative around which borough Leaders wish to join-together”.

The report added: “This would not imply a single London system, but a narrative which captures the rich variety of local models of integration of health and care which political leaders are willing to advocate for across London and which clearly demonstrate the powerful role of devolution in the objectives underpinning the narrative.

“This narrative is more urgent because of the pressures in social care and the likelihood that they will continue because of an absence of additional funding to the sector.”

It was noted that the new powers that may be gained through devolution can provide a platform for accelerating the development of borough-led integration models and so reforming the health and care system locally.

The report brought together developments connected to the reform and integration of health and social care and what decisions London council leaders should take in shaping how reform will be progressed forward and grown.

The review of the capital’s integration initiatives also identified risks and barriers to integration and recommendations for how to overcome them. It was also found that the pace towards full integration had been slower than originally hoped, saying that more still needed to be done for full health and social care integration to be completed by the target of 2020.

The report identified: “The health and adult social care sector is facing increasing pressures and integration, driven by multiple national policy initiatives, has long been seen as part of the solution to addressing these pressures. More recently, locally designed and driven integration plans have become more prominent, notably as a core component of the case for devolution.”

It went on to say: “The process of developing new models of integration of health and care has evolved and taken on a new, stronger emphasis in recent years.

“At its core, the policy drive behind the Better Care Fund (BCF) is that integration is key to improving a range of health related outputs and outcomes, often practically enabled through budget pooling and some shared governance.”

The report called on the London Councils executive to provide political guidance on how to build an integration narrative, and suggested the development of a policy platform to capture the core of borough-led initiatives.