Time for a health and social care reset

By Michael Kitts and Dr Tim Wilson

Most people recognise that integrated health and social care is a better solution for communities and individuals than a confused patchwork of siloed, over-lapping or duplicated services. 

Even in Westminster political parties are competing to see who can propose the best integrated healthcare solutions, from Andy Burnham’s whole person commissioning pilots, to whole place community budgets, pioneers and the top slicing of CCG monies for social care purposes. 

But, while there is an acceptance that integration is the right way forward, there is a suspicion – or
even fear – among some in local government that, rather than providing financial relief, integration, by redirecting activity towards community and social care, will place additional burdens on their already stretched social care budgets. 

We addressed this issue at our workshop at the LGC Summit in Marlow last week.  If as public leaders in a community, you believe that integrated care is the right thing to do, then you need to quickly establish that specific interventions, often providing 'pro-active' or 'upstream' care, genuinely work for all parties from a financial perspective. Otherwise, while helping the individual
concerned, it will not pass muster with the board or governing body that has a duty to their own organisation. 

The key to turning integrated care rhetoric into reality, first, is mindset.  Everyone needs to take an organisationally ‘agnostic’ view about existing arrangements, suspending current rules and mechanisms to establish a single vision for integrated care. All sides need to be working towards the same objectives across the whole care economy – with the patient or community at their heart – to achieve the outcomes they seek, as well as securing savings. 

But agreeing a shared vision for integration will only get you so far. Public sector commissioners need to create the right environment for providers to integrate and improve the quality and efficiency of services in order to manage demand with reducing budgets. This means exploring novel approaches to contracting, such as those being adopted in other countries, as well as increasingly in England, like contracts based on population outcomes. 

Achieving integrated care is not easy, but local government does need to start seeing it as a solution
rather than a cross to bear.  By working together, total care economy costs can be reduced and effectiveness improved, offering a sustainable approach that is essential if councils are to maintain
services in the face of rising demand.

A version of this blog first appeared in LGC.

Michael Kitts:
Read profile | Contact by email | Tel: +44 (0)1509 604025

Tim Wilson:
Read profile | Contact by email | Tel: +44 (0)20 7213 2147