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Health and social care reforms must be better communicated, MPs warn

The government and the NHS must improve how NHS reforms are communicated to the public, the Health and Social Care Committee (HSCC) has warned.

Rising demand and cost of health care means that services need to be changed and better organised around patients, and examples of NHS and care services working together to deliver better care has been happening for some time.

According to the committee’s report ‘Integrated care: Organisations, partnerships and systems,’ the government and national bodies are yet to explain the case for change clearly and persuasively, with a failure to consistently engage with local leaders in the design of service changes.

It says that there is an overuse of jargon and poor communication, which confuses not just the public, but health professionals too, along with changing acronyms, titles and terminology that “have allowed misunderstanding to fester,” fostering suspicion of the underlying purposes of reform.

Sustainability and transformation partnerships (STPs) and accountable care organisations (ACOs) have been polarising, with a High Court battle against ACOs famously backed by Professor Stephen Hawking before his death.

But, according to the committee, ACOs will not threaten the founding principles of the NHS and are unlikely to be led by the private sector.

The committee claims that reforms to better join up health and social care present an opportunity to “row back the NHS-internal market,” rather than threatening the integrity of the NHS. However, it says that the “litmus test” will be whether these changes improve the care, outcomes and experience of service users.

However, the committee says that further integration of services is “too often hampered by current legislation,” and is calling on the government to remove legal barriers that it claims are imposed by the Health and Social Care Act 2012.

The HSCC has recommended that representatives from the health and care community lead on the development of new legislative proposals for the government in order to rebuild the trust that previous top-down organisations have eroded.

If, following a the evaluation of pilots, the use of ACOs is extended, the committee has advised that they should be introduced into primary legislation as NHS bodies.

Dr. Sarah Wollaston, chair of the committee, said: “It is the triumph of our age that more people are living longer, but as MPs we too often see our constituents, their families and their carers grapple with local services that may be poorly organised around their needs and struggling to cope with the rising demand for care.”

She added: “Any effort to transform care will flounder and lose support unless it can demonstrate that patients and their families will benefit.”

The British Medical Association (BMA) agrees in principle with a more joined up approach, including greater collaboration between health and social care.

However, Dr. Chaand Nagpaul, BMA council chair, warned that the way in which transformation plans are being rolled out “lacks transparency.”

He added: “As we addressed in evidence to the recent judicial review on ACOs, the BMA is concerned that such transformation plans will operate within current procurement rules, which risks handing an area of the NHS’ budget to private providers through competitive tendering.

“Added to this is the insecurity of fixed-term ACO contracts which will require re-bidding every 10 years and which a provider can terminate and walk away from early. We are pleased that the committee agrees with the BMA’s call for legislative change to remove legal barriers imposed by the Health and Social Care Act 2012.”


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