Guest article: DHSC whitepaper on health and social care integration – Several ideas in search of money and staff

Guest article: DHSC whitepaper on health and social care integration – Several ideas in search of money and staff

The paper seeks to put more meat on the bones of the UK Governments 10-year vision for adult social care, People at the Heart of Care (01-Dec-21), which provided the very first take a look at health and social care propositions that will be funded by the ₤ 1.8 billion-per-year increase allocated for social care from the impending (01-Apr-22) 1.25 percent rise in National Insurance contributions levy (₤ 5.4 billion overall over three years).

On 09-Feb-22, the Department of Health & & Social Care (DHSC) released a whitepaper, Health and social care combination– Joining up take care of people, locations and populations, that “sets out measures to make integrated health and social care a universal truth for everyone across England, despite their condition and of where they live.”

In this post, William Lee, Policy and Parliamentary Executive of the British Healthcare Trades Association (BHTA), has invited the UK Governments plans for data sharing and a focus on results in its recent integration whitepaper but has called for a comprehensive, actionable strategy to enroll care across populations, locations and people.

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We invite numerous of the goals set out in the whitepaper, consisting of:

Prepare for information sharing (Section 4) across the NHS and regional authorities so that service shipment is faster, less fragmented, and frees clients from needing to duplicate the exact same details to several caretakers (with an objective to have digital, shared care records for all by 2024; this is specifically essential for those struggling with complex and/or several illness and conditions). Past NHS IT and data tasks, nevertheless, have actually often shown more complex, costly, and disruptive than prepared for, and we support the call from the Alzheimers Society to guarantee that plans in this location do not interfere with the immediate requirement for critical, non-emergency services to go back to typical.
A concentrate on results not outputs (Section 2) for organisations across health and social care, with application of shared results to begin from April 2023. There are currently encouraging examples of as-was medical commissioning groups (CCGs)/ emerging incorporated care systems (ICSs) working towards shared goals, developed with citizen-input and grounded in the needs of regional populations. We support these consultative and in your area driven approaches, which have actually long been called for by the NHS Confederation and others.

Were less sanguine about prepare for single-local-leader responsibility for shipment of shared results at the “place” level within ICSs, and goals to “motivate” NHS and local authorities to do more to line up and pool spending plans (Section 3). Both of these aspirations are extremely vulnerable to a weakness highlighted in the whitepaper– past” [over] dependence on relationships and soft levers, [which] can work well in areas where there are strong relationships, however are susceptible to changes in leadership,” and are not back-stopped by structural accountabilities (p. 26). No options or enhancements to resolve these vulnerabilities (detailed cogently by NHS Providers) are suggested– and, as the Health Foundation explains, “better combination in between services is no replacement for correctly funding them; the social care system in England is on its knees and main government financing over the coming years is hardly enough to meet growing demand, let alone broaden and improve the system.”

Most concerning of all, however, is the lack of detailed attention to the health and social care labor force (Section 5). There is a welcome program of assistance for training and advancement of personnel (in social care), however no consideration of the wider panoply of labor force concerns (huge vacancies, difficulty in recruiting/retaining personnel, lack of rewards to select health and social care as occupation), as illustrated by a chorus of reactions to the whitepaper:

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And, certainly, the paper is shot through with examples of successful integration projects and programmes already underway. Again, as BHTA highlighted in our comment on the UK Governments 10-year vision for adult social care, if the goal is to sign up with up care throughout individuals, populations and locations, a detailed, actionable plan is required– and this paper is still more “journey-planner” than real plan.

There are already motivating examples of as-was medical commissioning groups (CCGs)/ emerging integrated care systems (ICSs) working towards shared objectives, designed with citizen-input and grounded in the requirements of regional populations. No alternatives or augmentations to address these vulnerabilities (detailed cogently by NHS Providers) are suggested– and, as the Health Foundation points out, “much better integration in between services is no replacement for effectively funding them; the social care system in England is on its knees and main government funding over the coming years is hardly adequate to fulfill growing demand, let alone improve the system and expand.”

And, indeed, the paper is shot through with examples of successful combination jobs and programmes already underway. Once again, as BHTA highlighted in our comment on the UK Governments 10-year vision for adult social care, if the objective is to join up care across places, individuals and populations, a detailed, actionable plan is required– and this paper is still more “journey-planner” than real plan.

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” There was no mention of a nationwide labor force strategy […] and combination must include and involve the whole of the social care sector from local authority commissioners, through to voluntary and medium and small business (SME) companies of care.” (Skills for Care).

The answer to this appears to be extremely little.”.

” More combination is little great if there arent sufficient personnel to provide services– staffing lacks in health and social care are chronic, yet Government has no long-term strategy to resolve them.” (The Health Foundation).

(Skills for Care).

” Welcome actions […] None of this is possible without the labor force to offer that care.” (Royal College of Physicians).