Shadow health secretary says “if social care is allowed to continue to collapse it will drag down the rest of the NHS”, plus the rest of today’s news and comment
5.20pm Here are some reader comments on the Barker commission’s conclusions:
“Herein lies both a problem and an opportunity. We certainly need to integrate the way that health and social care needs are delivered. BUT is rolling together budgets or commissioners likely to achieve this? Evidence suggests not. Northern ireland, Herefordshire and a number of other places have had a single organisation commissioning both for years. The services have not integrated! What we need are new service models, which are able to send separate bills to health, social care, specialist, mental health commissioners for achieving different sets of outcomes for each! Then the service will be able to wrap around patients needs. There is an approach to achieve this that I’m working on with 3 health economies..but as yet we’re staying slightly off the radar…”
“I have to agree, the focus has to be less on structures and more about creating joined up solutions around people in localities. This is likely to be more effective in systems where staff are empowered to be creative, where outcomes not services are commissioned, where providers are rewarded for helping people to be more independent and well and also where there is less arguments over who owns what pot of money.”
4.35pm Accountancy body CIPFA has welcomed the Barker commission’s recommendations, but questions the long-term sustainability of measures such as ring-fencing budgets.
Chief executive Rob Whiteman said: “This report is very timely given the material pressures we are facing in the funding and delivery of health and social care.
“CIPFA welcomes the tangible proposals in the report for funding health and social care, in particular the options around extending means testing and payment.
“However we believe any new proposals must also address the long term issues facing the public finances. Without other measures, such as broader local tax raising powers, ring-fencing is not a sustainable solution in the wider context of tighter public spending. Indeed ring-fencing could as an unintended consequence squeeze still further other areas of public expenditure, for example skills, defence and criminal justice which are also under increasing pressure.
“The immediate task of tackling the imminent crisis in health and social care this year should encourage the government to give immediate consideration to these proposals, as any transition to a long term solution will inevitably take time and cost money.”
3.45pm HSJ, working with NHS Employers, the NHS Leadership Academy and the British Medical Association, is seeking to celebrate the outstanding contributions professionals from black and minority ethnic backgrounds make to healthcare – and nominations are now open.
Some 67 per cent said they were against paying more income tax so that the government could allocate more cash to the health service, a Populus poll found.
The respondents said the NHS would benefit more from being reorganised than it would from extra money, with 60 per cent saying this in a survey, and 12 per cent disagreeing.
2.30pm Meanwhile, the Foundation Trust Network has described the commission as a “significant new framework for a fairer and more consistent alignment of health and social care”.
Saffron Cordery, director of policy and strategy, said: “We congratulate The King’s Fund and the Commission for proposing a significant new framework for a fairer and more consistent alignment of health and social care, underpinned by rigorous analysis and evidence. The options outlined should be a catalyst for debate to ensure integration between the two systems is fit for purpose, and that both systems have the funding they need to deliver sustainable health and social care for future generations. The proposals will not deliver immediate solutions but do establish a welcome direction of travel.
“We must also ensure that any new commissioning structures, such as Health and Wellbeing Boards, have the appropriate capacity and capability to commission these integrated models of care. Change on this scale cannot happen overnight and certainly not without provider engagement at its core.
2.00pm NHS Confederation’s chief executive, Rob Webster, has broadly welcomed the Barker commission.
He said: “Back in May, the 2015 Challenge Declaration set out the main challenges facing our health and care system. This Commission, led by Dame Kate Barker, has outlined in absolute clarity how we might move to solve some of these challenges and is a hook for the debate on how much we invest, where we put that investment and how we join health and social care together.
“While we might not agree with all the recommendations it puts forwards, we welcome its contribution to that debate. We know the impact funding and demographic pressures have on health and social care, and this report highlights the funding gap that is likely to exist in both budgets in the future.
“There does, however, appear to be a political vacuum on many of these issues. The task for politicians now is to address the real financial challenges facing the health and care system and establish a vision for how they want services to be funded. The NHS as ever is committed to ensuring care is delivered. The 2015 Challenge process will continue to contribute to this debate and the NHS Confederation will be the voice of NHS leadership as we look to develop a positive future for the health and care system.”
1.30pm The Barker commission has delivered a huge blow to the idea of charging for health and social care, argues Julian Le Grand, professor of social policy at London School of Economics in our Comment section.
1.10pm Brent council is already working to integrate health and social care, but threats to funding are a concern, says councillor Krupesh Hirani, the council’s cabinet member for Adults, Health and Wellbeing.
He said: “Full integration of health and social care is what we should all be aspiring to, and in Brent, we have already sown the seeds with our Whole Systems Integrated Care pilot.
“However, while spending on health is increasing, although not at a fast enough rate, funding for adult social care and local authorities is being cut between a half and third over the next two to three years, so the pressure on the whole system is huge, but it is even harder on councils such as Brent.
“The Commission’s recommendation requires an increase in public spending on health and social care to rise to 11 to 12 per cent of the UK’s GDP, however current government spending plans will bring spending in this area to only 8.5 per cent of GDP in ten years time.
“Without a sustainable funding approach to local government and the National Health Service it will be impossible to deliver this aspiration.”
This is the core message at the heart of an integrated approach to the health and social care system set out this week by Kate Barker, the economist and former member of the Bank of England’s monetary policy committee.
The ultimate vision, outlined by the King’s Fund commission on the future of health and social care which Ms Barker chairs, is not contentious. But the means of realising its ambition could prove controversial.
11.40am In our Comment section, professor of social policy at London School of Economics, Julian Le Grand, argues that the Barker commission has delivered a huge blow to the idea of charging for health and social care.
11.15am The King’s Fund have put together an illustrated summary of the commission into health and social care.
11.10am The Barker commission on combining health and social care is trending on Twitter.
Here are a few responses:
Andy Burnham - “The #barkercomm report is an authoritative endorsement of Labour policy of Whole Person Care and the full integration of health and social care”
Sue Ryder (charity) - “We welcome #barkercomm call to provide free social care at end of life and believe this should be available to everyone”
10.16am The Nuffield Trust’s chief executive, Nigel Edwards, has called the Barker Commission report “impressive” and sees merit in the suggestions looking at how to raise the required funds.
He said: “This impressive and clearly argued report clearly sets out a new vision for the stubborn problem of how to adequately fund health and social care for the future, and is to be warmly welcomed.
“But as we don’t know how many people with critical care needs are currently paying for their own care or receiving it informally, there is a risk that the Commission’s central proposal may result in new battlegrounds emerging if numbers eligible exceed the budget available for free care. This will require careful consideration from policymakers and commissioners if it is not to undermine the proposal.
“The Commission acknowledges that funding this will mean making some hard choices, and sets out a range of ways of paying for extended social care. Their suggestion to overhaul prescription charges has merit, provided it does not deter those who are the heaviest users of medicines from accessing their medication. It is also logical to target older age groups more broadly as a source of funding increases on the grounds of fairness, and the Commission’s proposals on winter fuel allowances and TV licenses echo those made by the Nuffield Trust previously.
“However, any measures that remove benefits from older people or tap into other sources of wealth amongst this age group will not be popular. There is still very limited public awareness of just how expensive intensive personal care can be, whether delivered at home or in an institution, and just how many families are exposed to the risk of paying for it out of their own resources under the current system. The proposals contained in this report are based on the argument that society should collectively meet those risks, just as they do for serious health problems.”
9.50am Shadow health secretary Andy Burnham has responded to the report from the King’s Fund commission on the future of health and social care in England.
He said: “We welcome this bold and timely report which endorses Labour’s call for a new settlement for the NHS and the full integration of health and social care.
“The stark truth is this: if social care is allowed to continue to collapse, it will drag down the rest of the NHS. This is precisely what is happening under this Government, as people who have seen support withdrawn are ending up in A&E in increasing numbers. I am clear that the ever-increasing hospitalisation of older people is no answer to the ageing society.
“The simple fact is that there is no sustainable future for the NHS in the 21st century without a long-term solution for social care. It is only by better supporting people and their carers that we can avoid huge expenditure on avoidable hospital admissions.
“This is why Labour is committed to building an NHS for the whole person, providing personalised care in people’s own homes with a single point of contact for all their needs.”
This is the conclusion of economist Kate Barker, a former member of the Bank of England’s monetary policy committee who chaired the King’s Fund commission on the future of health and social care.
In her report A New Settlement for Health and Social Care Ms Barker called for a major expansion of free social care and for councils’ care budgets to be pooled with a “significant” proportion of the NHS budget.
7.00am Welcome to HSJ Live. We start the day with the news that NHS England has proposed devolving “year of care” budgets covering NHS and social care to individuals with complex needs as part of its effort to help integrate services and increase personalisation.
In a prospectus published this week, the commissioning body set out plans to introduce “integrated personal commissioning” in areas keen to make rapid strides towards creating joined up, personalised care.