Government White Paper : 'Integration and Innovation: Working together to improve health and social care'

The Government’s White Paper unveiling proposals to integrate health and social care has been welcomed by care providers, although it does not address the issue of care funding.

Every part of England will be covered by an integrated care system (ICS). These will be made up of an Integrated Care System (ISC) NHS Body and a separate ICS Health and Care Partnership, bringing together the NHS, local government and partners

• The health and care minister will be given more power to make direct payments to adult social care providers when needed (only be in exceptional circumstances)
• The Health and Care Bill will include a new duty for the Care Quality Commission to assess local authorities’ delivery of their adult social care duties. The Secretary of State would have the power to intervene, if the CQC decides a local authority is failing to meet its duties
• The new proposals will see an end to competitive tendering for contracts, with the NHS and local authorities left to collaborate and run services themselves
• The Healthcare Safety Investigations Branch would be put permanently into law as a Statutory Body
• Legislation will help support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed
• The Secretary of State for Health and Social Care will be given the power to directly introduce, vary or terminate water fluoridation schemes.

Although care providers welcomed proposals to reform the way the NHS is run, they urged the Government to press on with vital reform of social care at the same time.

The Independent Care Group (ICG) warned care providers looking after older and vulnerable people were in danger of again being left the poor relation to NHS care. ICG Chair Mike Padgham said: “It is welcome news that NHS reform is happening but aside from mentioning social care, the government hasn’t gone far enough in outlining its future. It is vital that both are reformed at the same time, otherwise social care will be left behind once again…We have argued for more than a decade that NHS care and social care need to be equal partners and ideally merged. But how can that happen when £8bn has been cut from social care budgets since 2010, some 1.4m people are living without the care they need and there are 100,000 vacancies for social care staff?”

Bob Hudson, a visiting professor in Public Policy in the Centre for Health Services Studies at the University of Kent, echoed this sentiment by saying, "Given the recognition of ‘care’ in the White Paper title and the emphasis on ‘integrated care’ throughout, there is remarkably little recognition or understanding of the sector. "There is little to dispel the fear that social care is simply perceived as a handmaiden to the priorities of the NHS, especially the reduction of hospital costs. Not only will the local government voice be relatively weak, but the powers given to the Secretary of State could see councils losing control of their social care and public health services to the priorities of the ICSs."

A Bill will be laid before Parliament later in the year.

The White Paper is available here: Integration and Innovation: working together to improve health and social care for all (publishing.service.gov.uk)