Integrated NHS and adult social care sector could improve care for all

Reviewed by Emily Henderson, B.Sc.Feb 9 2022

Patients will receive better, more joined-up care under new plans announced today to improve the links between health and social care.

The Integration White Paper sets out a vision for an integrated NHS and adult social care sector which will better serve patients and staff.

Despite the best efforts of staff, the current system means that too often patients find themselves having to navigate complex and disjointed systems. Those with multiple conditions can be left feeling frustrated at having to repeatedly explain their needs to multiple people in different organisations, while others can end up facing delayed discharge because the NHS and local authorities are working to different priorities in a way that isn't as joined up as it could be.

The White Paper sets out some of the ways health and care systems will draw on the resources and skills across the NHS and local government to better meet the needs of communities, reduce waiting lists and help level up healthcare across the country.

This includes -

• Better transparency and choice: if local authorities and the NHS share data and are more transparent about their performance, the local population will be able to see how their areas' health and care services are performing and make decisions about their own care.
• More personalised care: linking GPs with wider forms of community support - such as social prescribing - could allow care to be more personalised which would help reduce the need for people to have more expensive, invasive medical treatment.
• Earlier intervention: integration will help people to access to the right services at the right time - including specialist services - which could mean earlier intervention that could prevent diseases from progressing and reduce the need for invasive and expensive interventions late in the day.
• Clear communication: integration will mean patients having a single digital care record so they can book appointments, order prescriptions, and communicate with their care providers on one platform while those involved in delivering health and care services can access the patient's latest information. Not only will this save time, it will help ensure a patient doesn't have to repeat themselves so many times, and professionals will have the information they need to make care plans that work for the patient.
• Improved access to social care services through NHS data sharing: currently local authorities cannot access all NHS data to make decisions about access to social care services. An integrated system would allow the NHS to notify a local authority straight away if a person requires social care support.
• Better treatment: managing diseases in the community through better join up between primary, community and hospital services means better treatment for patients.
• Better NHS support to care homes: integration between hospitals and social care would mean more specialist support so care home residents could be treated before they get unwell and avoid having to go to hospital.
• Coordinated services: better integration across health and care will reduce the burden on people to have to coordinate between different hospital specialists, GPs, social care and local authority services themselves.
• More flexible services: aligning financial incentives and pooling budgets will mean that the NHS and local authorities can use their resources more flexibly to benefit patients.
• Better value for money: reducing duplication and waste will mean that NHS investment can be spent in ways that benefit patients and deliver savings for social care, ensuring value for the taxpayer.

Prime Minister Boris Johnson said:

The pandemic highlighted what our fantastic NHS and local government can achieve when they work together - from delivering the phenomenal vaccine rollout to supporting those who were shielding.

We now want to build on these successes, joining up health and social care even more to deliver the best possible care - whether you want to see a GP quickly or live independently with dementia.

These plans will ensure no patient falls between the gap, and that everyone receives the right care in the right place at the right time."

Health and Social Care Secretary Sajid Javid said:

Better integration is vital to stop people falling into the gaps between health and social care.

Ensuring our health and care systems work in unison will mean we can support hardworking staff, provide better care to patients and deliver value for the taxpayer.

Our Integration White Paper is part of our wider plans to reform and recover the health and social care system, ensuring everyone gets the treatment and care they need, when and where they need it."

The plans set out in the white paper will ensure care is more personalised and accessible and remove the burdens on patients. Better information sharing will mean people will no longer have to remember key facts such as dates of diagnosis or medicines prescribed, taking pressure off patients to coordinate their own care.

Local health services will be tailored to the specific needs of the community to ensure the right services are available. This could mean for example more diabetes clinics in areas with higher obesity, or additional support for people to stop smoking in communities where there are higher numbers of smokers.

The Integration White Paper is the next step in delivering the government's promise of a health and social care system fit for the future. It builds on both the Health and Social Care Bill and the People at the Heart of Care White Paper which set out a ten year vision for social care funded through the Health and Care Levy, and follows the delivery plan for tackling the COVID-19 backlog of elective care. Dedicated plans to tackle health disparities are set to be published in due course.

Integrated approaches are already being pioneered in many areas.

Through their contact with people in the community, pharmacies in Sutton, recognised a growing problem of loneliness and isolation, so worked with colleagues across the health and care system in that area to identify those most in need and link them up with services that were best placed to support them.

In Portsmouth, local authorities, health trusts and voluntary organisations combined their knowledge and expertise to improve support for vulnerable people in the community across a range of different services including health visiting, school nursing and learning disability support.

And in Tameside and Glossop, an electronic staff record system has enabled data to be fed into COVID-19 situation reports, so that staffing levels can be managed more effectively based on live data.

Integrating services in other parts of the country will help staff to treat increasingly complex conditions and combat health disparities, including by harnessing new and innovative technology.

To help embed integration across the country, there will be a single point of accountability at a local level to ensure closer links are forged between health and care systems, with consistent and compatible targets.

Michael Gove, Levelling Up Secretary, said:

The past two years have highlighted the persistent health disparities in this country. As we recover and level up, it is right that we draw on our experience of the pandemic to bridge the gaps that are holding us back - between health and social care, between health outcomes in different places and within society.

This is what our important Integration White Paper aims to achieve, by bringing together the NHS and local government to jointly deliver for local communities, and why I am so happy to champion its ambition."

Mark Cubbon, NHS England chief delivery officer, said:

The NHS is committed to making it easier for patients to get the care they need, regardless of the service or services they are using, and that is why we have already established 42 Integrated Care Systems (ICSs) across England as part of the Long Term Plan to ensure all parts of the NHS and its partners are working effectively together.

The pandemic has shown us what we can achieve when we work together, and joining up services across health, social care and the wider community is key to improving efficiency and giving our patients the best care possible."

Paul Najsarek, Solace spokesperson for Health & Social Care, said:

This White Paper is a welcome step forward to improving health outcomes in communities across the country.

The potential for local government to make a real, positive difference to the people and places we serve is immense, but it will only be by working together with health, voluntary and community sector partners, and playing to our respective strengths, that we will be able to deliver meaningful change by better treating and preventing illness, improving public health, and addressing inequalities.

In particular, local authority chief executives have a crucial and unique role to play both in bringing together disparate funding streams in place and galvanising not just their councils but key local stakeholders to contribute to this incredibly important agenda."