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Health and social care integration plans at risk due to funding shortages

Key health and social care bodies have set out their vision for how services can be integrated by 2020, but warned it’s at risk because of funding shortages.

‘Stepping up to the place: The key to successful integration’ is a joint report from the LGA, NHS Confederation, Association of Directors of Adult Social Services (ADASS) and NHS Clinical Commissioners which argues that local systems should embed integration as ‘business as usual’ in order to achieve it by 2020.

However, it says that service integration may not be possible until national leaders address the shortfall in funding, particularly in public health and community services.

Cllr Izzi Seccombe, the LGA’s community wellbeing spokesperson, said: “Health and social care faces major financial and demographic challenges meaning we have to change our model of support. We believe a shared local vision based on local populations’ health needs, and developed with local leaders is the most effective way of using public resources to improve health and wellbeing.

“The central purpose of integration is to meet the needs of communities, achieve the best possible health and wellbeing outcomes for residents, enable them to keep well, remain independent and allow them to contribute to the prosperity of their local areas.

“Political leadership and democratic accountability will be crucial in ensuring that integration plans are focused on getting better health outcomes, improving services and addressing the financial challenges.”

The County Councils Network warned recently that problems affecting the NHS, such as delayed transfers of care, are being made worse by cuts in social care funding.

The new report also warns that full integration may not be possible because of the disparity in funding between the health service, which is free at the point of access, and social care, which is means tested.

It says that greater dialogue is also needed between local political, clinical, commissioning and community leaders in order to begin action to implement integration. This should include ensuring that local systems have the right level of accountability, resources and staff training to deliver the changes needed.

However, a recent PSE investigation revealed that Council involvement in the ongoing and arguably momentous Sustainability and Transformation Plans (STPs), designed to integrate health and social care across 44 ‘footprints’, has been inconsistent nationwide. Our FoI investigation also found that over two-thirds of councils had been shut out from STP health leadership talks.

Harold Bodmer, president of ADASS, said: “The report outlines a number of health and social care services that have made significant progress to integrate and transform care.

“While there are excellent examples, more needs to be done at a national level to provide support, guidance and investment in the vision so that all local leaders across the country can work to make transformation happen at a faster rate.”

The organisations will publish a self-assessment toolkit to help local system leaders judge how capable they are of delivering integration by next month.

Their vision for an integrated system includes creating personalised care plans to place the individual at the heart of services and allow them to address their own care, and preventing problems from developing by addressing wider issues which affect the health of the population and lead to health inequalities.

They also say that greater shared leadership is needed, potentially including co-commissioning health and social care services, reforming payment systems and ensuring a free flow of information.

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