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Public sector leaders urge health and social care services to kick-start integration

NHS Confederation has launched a new report outlining how and why health and care services can be integrated more quickly.

The report, Stepping up to the place: the key to successful health and care integration, was published in conjunction with Local Government Association, Association of Directors of Adult Social Services (ADASS) and NHS Clinical Commissioners.

For the first time, the organisations have drawn out their whole-system vision for integration based on forming care around the needs of individuals in a society with increasingly chronic and complex health needs.

Janet Davies, chief executive and general secretary of the Royal College of Nursing (RCN), offered her support for better integration as outlined in the report.

She said: “In recent years, the consensus in health and social care has been that better integration is both desirable and necessary.

“Health and care services need to deal with an ageing population and many people with multiple, long-term conditions.

“Sadly, the rhetoric seldom matches the reality. There are excellent schemes, many of them nurse-led, which do integrate care in certain areas or for certain conditions, but this needs to be the norm.

“Nurses work at the interface of health and social care, and nurse leaders have a crucial role in designing services which work for patients.

“With strong integration, more focus can be given to preventing conditions from deteriorating, and building care around every individual and their needs.

“Without that focus, it is too easy for healthcare to become just about treating instances of illness when they become acute and require hospital treatment.”

The report says that integration will create a “collective leadership, which drives culture change, accepts responsibility for achieving the vision and ensures commissioning for and provision of better outcomes”.

However, the report also identifies challenges, including the lack of funding, which has put plans to improve patient care and the sustainability of the whole health and social care sector at risk.

The report outlines nine action points that can make integration happen.

These include creating long-term payment and commissioning models by “jointly identifying and sharing risk”, which means aligning commissioning across all budgets, sharing long-term planning, which charts a course to transform services and improve health, wellbeing and financial sustainability.

The report emphasises the need for a cultural shift towards preventative healthcare, as well as support from national leaders to address the shortfall in funding in public health and community services.

Stephen Dorrell, chair of the NHS Confederation, said: “This report sends a clear message that to improve the standard of care that we deliver to people we must better integrate our health and social care services.

“The NHS continues to face unprecedented demand and challenging financial circumstances.

“Against this background, we need to make sure we are utilising all the collective resources of a 'place' to benefit our local communities.

“There is now a real urgency to deliver on this ambition. Our priority now must be to turn rhetoric into action.”