Short-term thinking is still the enemy of integrated health and social care
It’s interesting to read the contrasting conclusions that accompanied two recent reports on delivering integrated health and social care.
The Department of Health-commissioned survey was carried out by the Policy Innovation Research Unit to provide an early evaluation of the Integrated Care and Support Pioneers Programme.
The report concludes that the survey found limited evidence of changes to services and that it has failed to remove barriers to joined-up care.
The Local Government Association-commissioned report was produced by Carnall Farrar, whose researchers conclude that “in some areas significant impact has been achieved through integrated care approaches”.
It was in 2013 that Norman Lamb, then care and support minister, announced the 14 pioneers that had been selected as a “starting gun” for the NHS and local authorities “…to get local health and care services working together… in the interests of the people they serve.”
However, in response to the DH survey, Mr Lamb said he was in constant dialogue with NHS England during his time as a minister regarding “inadequate” support for the pioneers, claiming they were not taking the programme seriously enough.
The LGA has long advocated the benefits of integrated, person-centred care as a key vehicle to improve people’s health, alongside bringing financial sustainability to the health and care system.
Its report examines each case against a range of factors including care model, leadership, payment model and information flow. In contrast to the DH report, the LGA report highlights successes such as 36 per cent reduction in emergency admissions, halving the rate of growth in health and care costs and “double digit” improvements across a range of outcomes.
Whilst we witness and help to deliver improved outcomes, we also witness and experience systemic barriers to integration, such as rules around information sharing
So what conclusion should we reach? As a supplier of technology and services that support integrated healthcare and social care, including to localities included in the LGA study, Civica welcomes all initiatives that underpin closer working between care providers focused on patient-centric service delivery.
Whilst we witness and help to deliver improved outcomes, we also witness and experience systemic barriers to integration, such as rules around information sharing, and the effect of competing pressures; notably financial pressures undermining efforts to integrate care by diverting resources away from transformation to “fire-fight”.
For as long as the obsession with deficits remains, short-term thinking will continue to undermine long-term imperatives.
David Roots is executive director of health and social care at Civica.