Labour plans to introduce an ‘accountable provider’ for frail older people under its 10 year plan for the NHS funded via a ‘year of care tariff’. This suggests a new role for trusts as lead providers of joined up health and care services.

However, Labour’s plan sets out an extremely relaxed timetable for local health economies to adopt this way of working. It pledges only to encourage areas to “consider” the right future model, and move towards it at “the appropriate pace”.

The 10 year plan explains that a Labour government would develop a year of care tariff to pay for all health and social care for people with complex needs, “such as frail older people”.

“Over the next 10 years, we would want to see this type of payment system developed for larger segments of the population,” it says.

“This means that the accountable provider, who will have to pay more if clients deteriorate and need hospital care, will have a much stronger incentive to invest in preventing problems.”

Monitor is already working on developing a capitated budget for the care of people with long term conditions, as announced in the NHS Five Year Forward View.

Labour’s vision reiterates the theme of “whole person care” set out in detail last year by Sir John Oldham in a report commissioned by the party, and describes the desired end point as being “a single service, on the basis of a single year of care budget for those with complex needs”.

However, there is no firm deadline for this destination to be reached. “The journey to that end point will be determined locally, with flexibility over when and how,” the 10 year plan says. “We will encourage health communities to consider the appropriate model for their local health and care service over the next 10 years, and to move there at an appropriate pace.”

The plan stops short of promising to put acute trusts in charge of all health and social care, although it does restate Labour’s existing policy that NHS trusts should be the “preferred provider”, and seeks to curtail the role of the private sector.

Shadow health secretary Andy Burnham has long argued that acute trusts should expand to become integrated care organisations.

Under the Labour plan they could begin to provide social care services via 5,000 new NHS “homecare” workers.

This “new arm” of the NHS workforce will be funded via £2.5bn of new funding first announced last autumn at the party’s annual conference, and will “provide new opportunities for training and career development” in the social care workforce.

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