What is the best approach for integration of health and social care provision?

January 17, 2019   By Simon Goacher, Partner and Head of Local Government, Weightmans

Financial constraints combined with escalating demand for services continues to be one of the biggest challenges that public bodies face. In order for the public sector to face the challenges of the future head on, efficient collaboration – and integration – is key.

Weightmans was delighted to host the NLGN Innovation Exchange on health and social care. Delegates came from across the country to discuss integration between the two – how it currently works, how it can be improved and lessons to learn for the future.

It makes business sense to integrate processes in order to drive efficiency and deliver value for money. Almost all local government and NHS bodies have explored and implemented this – but how successful this has been varies wildly.

This issue remains a huge priority for the health and local government sectors. The rising costs of care and health provision to meet the demands of an ageing population means that the seeking of solutions continues to be one of the most pressing issues for organisations across the public sector.

Whilst this report focuses on the integration between the NHS and local government, it is worth considering how these institutions work with other partners such as charities, the voluntary sector, and the private sector. The importance of these relationships cannot be underestimated – they will be crucial to the success of delivering effective social care in the future.

The Government Green Paper is still eagerly awaited. There has also been a judicial review challenge to the Integrated Care Provider contract – NHS England successfully defended the case in the High Court and this decision was upheld by the Court of Appeal in December 2018. However, the challengers are seeking permission to appeal to the Supreme Court.

The NHS Long Term Plan was also delayed but has now been published. This makes reference to the need for more integrated care systems with such systems to be in place in all areas by 2021. However, in the absence of a clear strategy for the provision of social care and, in particular, different legislative and funding regimes for health and social care, achieving this vision will not necessarily be easy.

Against the uncertain background practitioners are seeking and implementing practical solutions to improve services and outcomes for people. At the innovation exchange some of the key messages that emerged were to not be afraid to try new approaches and that cultural issues can be a barrier to achieving success and work needs to be put into ensuring that these are understood and addressed at an early stage of any integration project.

There was also much discussion about the benefits and drawbacks of different approaches and whether bottom up approaches are more likely to succeed than top down. Ultimately truly successful integration needs commitment and alignment at all levels if it is to succeed.

There are a number of different ways that integration can work. With increasing financial pressures and constant uncertainty as to whether either NHS or local government funding will be enough to reach demand, all councils need to find an integrated solution that works for them. We are delighted to have worked with NLGN to produce this report which will contribute to the debate on this vital issue.

In September 2018, NLGN partnered with Weightmans to host our Innovation Exchange on health and social care at their offices in Manchester. All of our Innovation Exchanges produce a detailed Insights Report available exclusively to NLGN members. For more information on membership, please contact our Head of Network, Richard Nelmes.

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