Integrating health and social care: Where next?

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The coalition government has made clear its commitment to the integration of health and social care in its proposals for reform.

In the context of the intense financial and demographic challenges facing both health and social care, this paper offers a fresh assessment of the prospects for integrating health and social care and the opportunities and challenges arising from the government's proposals.

In the autumn of 2010, The King's Fund held two seminars, bringing together senior policy experts and NHS and social care leaders to discuss the barriers and aids to integration at national and local levels and the financial challenges facing all services.

This paper draws on the discussions that took place at both seminars which sought to consider the following questions:

  • Will the coalition government's policies create conditions for the successful integration that has eluded the many previous initiatives?
  • What opportunities could GP-led commissioning offer to develop new approaches to integrated care?
  • How far will pressures on social care budgets – and the productivity challenge facing the NHS – hinder or help integration?
  • What policy changes or adjustments would be helpful in promoting closer working of the two services?

Discussion at the seminars suggests that the success of health and social care integration will depend on a number of factors:

  • the scale and pace of change, which in some places could undermine local achievements in bringing services closer together
  • the extent to which GP consortia are committed to partnership working and can be supported in their new roles
  • the ability of health and wellbeing boards to promote integration
  • how far financial pressures will help or hinder shared planning and use of resources
  • the unknown impact of extension of choice and competition
  • whether three separate outcomes frameworks for the NHS, adult social care and public health will offer sufficient incentives for aligning services around the needs of people rather than organisations.

Read the related paper: Integrating health and social care in Torbay