Policy makers should beware of thinking that integrating health and care services will save money, Sir David Nicholson has warned.
The Commissioning Board chief executive said he was “worried” when he heard “people from the Treasury” discuss integration as way of delivering further savings.
He said: “My response to that is, ‘I’ve already spent it’, in the sense that we’ve built [the projected efficiencies from integration] into the thinking about QIPP. There’s not an extra bit on top of that you can do – so don’t spend it twice.”
Commentators have speculated that Conservative policy makers may look to greater health and social care integration as a way to drive down costs and therefore reduce the extra funding requirement identified in Andrew Dilnot’s commission into the cost of continuing care.
Sir David said integration was a priority, but “not the panacea to everything”.
He added: “I do think we need to be much more systematic about it. Whilst integration is a lot about behaviours and attitudes there’s also some things you need to do – that basic information about the patient group you’re talking about, risk stratification, financial incentives being aligned. All those things need to be done to make it a reality but it is absolutely part of both improving the quality of services, but also making sure that we manage the developing demand for hospital services.”
He praised integration work underway in North West London as “very good”. The McKinsey-led integrated care pilot attempts to square the payments system to incentivise acute providers, general practice, community care, social care and mental health to reduce admissions.
Sir David said: “I’m thinking about how we can use that learning to be much more rigorous about integration in the future. It sets out a series of steps you have to take.”
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Nicholson: savings from integration 'already spent'