Well said, perhaps NHS IC for Health & Social Care is aleady working on it? or maybe QIPP is?
If the DH is serious about joining up health and social care, perhaps the new Vital Signs must-dos for the NHS will include a compulsory indicator on joint commissioning or integrating care pathways across the joins?
We do need more community based health/social care services, whoever provides them. With an ageing population local access is essential.
Over the last 4 years in Southwark, we have been running 'leadership for integration' programmes in Southwark, focussing on the practical realities for individual managers and team leaders. Action Learning achieving real progress toward integration - and removal of the bunker mentality you mention. And I agree the reaction to pressure can be to revert rather than move forward with change.
Currently, the divide is focused on services and even more on professionals. For the average user and carer, the divide is primarily one of barriers. The proposals outlined in the Green Paper Shaping the Future of Care Together cry out for integration of health and social care. By the time the reforms are introduced, significantly more 'health' services will be provided in the community and will need to be supported by at least an equal growth in 'social' care provision. The division between what is 'health' and what is 'social care' will inevitably narrow, particularly as personalisation becomes embedded.
Do you not think this is already happening? There is always key people who if you watch their movements the strategy shows itself. You only have to look at the 1997-2002 LEEDS HEALTH AUTHORITY CONSULTATION DOCUMENTATION I have a copy if required? to see the plan unfold. Key players all have key positions for this to happen now or in the next twelve months.