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Better together? The integration of health and social care

Guest blog by Anna Galliford

Has the time finally come for a real commitment to integrating our health and social care systems? Can families look forward to a future where they aren’t told, ‘Sorry, that’s not my department; you need to speak to someone else?’ A future where support workers don’t spend precious time trying to get through to different people in a myriad of different departments, repeating the same story over and over, just to help one client?

This is a long-held debate, but with a general election imminent and political parties rallying to win support, the integration question is once again making the news and high up on the political agenda.

The current government’s £3.8bn Better Care Fund proposal is intended to support the transformation of health and social care services in the UK. At the Labour party conference, Andy Burnham promised to coordinate care by bringing social care and NHS bodies together into integrated care organisations. As he put it: “coordinating all care – physical, mental and social”.

This is welcome news to many of us in the social care sector, as – like local authority executives – we see the costly effects of misaligned care services on an almost daily basis.

There is no doubt the current system is failing. It is too easy to palm someone off on another department, or make the wrong decision because the facts of someone’s situation aren’t seen together. This can be a particular problem for people with complex health or developmental needs.

We also see how the lack of integration can increase the cost of care in the long-term, and most importantly we see how it can reduce independence and the quality of people’s lives.

Bridging the gap

Integration has the potential to improve the provision and efficiency of care but only if it receives sufficient consultancy and funding to make a real impact. This is why it is vital that we make the case for integration. Policy makers need to talk to those who work with the people who it will most affect, and find out what is needed.

A closer relationship between health and social care services would mean that people no longer lose support when moving from one service to another – for example moving from children’s to adult’s services or moving from hospital to home – and their needs can be continuously assessed by one team. We shouldn’t just stop at health and social care though; we need to enable closer working relationships between all agencies such as housing, employment and education.

Unlocking opportunity with long-term planning

We know from our latest piece of research, A Plan For Life, that integrated care will make long-term planning much more possible and began a much-needed discussion on the best ways to plan care. Local authorities told us that the current state of social care planning is illogical, as endemic short-term planning is leading to higher costs.

Integration offers the opportunity to plan further ahead and improve the appropriateness and quality of health and care services. We all know that any new model of service delivery needs substantial financial investment to be implemented and supported. These costs need to be looked at in light of the savings that could be made by giving priority to long-term planning. By taking the long view we will not only improve the way health and social care services integrate, we will create efficiencies and make a real difference to people’s lives.

Tread carefully

The Better Care Fund’s proposed budget involves moving funds from existing NHS services, creating uncertainty for local authority planning budgets, and leaving both health and social services vulnerable. We need politicians to consult with the people these changes affect the most, and commit to making the necessary funds available.

We also need politicians to start articulating their vision of how the system will work in practice. I fear that without sufficient commitment, integration will remain a promise not a reality, and could miss a vital opportunity to transform people’s lives.

Anna Galliford is chief executive of FitzRoy, a national charity that helps people with learning disabilities to live more independently.


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