Poor integration in local services means older people are losing out on personalised, effective and responsive care, according to the Care Quality Commission (CQC).
After reviewing eight health and wellbeing board areas, the CQC has concluded that although there is widespread commitment to integrated care local leaders, including commissioners, were unsure of how to put it into practice.
The report, Building bridges, breaking barriers, found “organisational barriers” are causing services to fail to share information, leading to older people having multiple care plans.
Furthermore, the CQC found a widespread lack of knowledge among professionals of how these care plans should be written and reviewed.
While there were some examples of good integrated care, the CQC report said that many were “short-term or reliant on partial or temporary funding and goodwill between different providers”.
The report also found that failure to integrate and a lack of clear information, meant older people and carers were left to navigate complex systems themselves.
This often resulted in people “falling through the gaps” and only being identified in response to a crisis or a hospital admission.
JP Nolan, head of nursing practice at the Royal College of Nursing (RCN), said: “There has been plenty of talk about improving the integration of services but very little meaningful action, and it is the most vulnerable people using the health service who are paying the price.
“Older people are the most likely to have multiple conditions, which need to access many different services, and they deserve joined up and person-centred care.
“When one part of the health and social care service starts to struggle, it has a knock-on effect, and it is patients that suffer. Integrating services is vital, and so is ensuring that all parts of the system are properly funded. Ring-fencing one part while cutting budgets elsewhere does nothing to help the most vulnerable patients.
“When different parts of the system do not work together effectively, it can cause delayed transfers and poor care. This is not only expensive for the health service, it causes so much distress to patients and their loved ones.”
Where integrated care was successful, the CQC found that local leaders worked closely across health and social care services to reduce duplicated efforts and use resources more effectively.
In response, the CQC is recommending health and social care leaders move forward with the vanguard programme and use the Sustainability and Transformation Plans (STP) to develop a shared understanding of integrated care.
Meanwhile, the CQC is urging commissioners and providers to involve older people in decision-making about their care and supply clear information about services that are available.
The regulatory body is also recommending that NHS England and Association of Directors of Adult Social Services (ADASS) work on a national system to identify older people at risk of hospital admission.
David Behan, CQC’s chief executive, said: “Older people who use health and care services tell us that they want their services to be joined up and work together.
“This study found examples of effective integrated care but these small steps need to become significant strides to move joined-up services into the mainstream. Everyone deserves seamless quality care, regardless of how many services are involved in delivering it and regardless of how complex your needs are.
“Local leaders should build on the opportunities offered by initiatives such as the new care models vanguard programme to deliver joined up care.”
The population over the age of 65 in the UK is projected to rise by 40% in the next 17 years to nearly 17 million, said the CQC in a statement.
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