The Government’s proposals for health and care integration are set out in its recently published White Paper, Joining up care for people, places and populations which was first announced in July 2021 alongside the Health and Care Bill. The White Paper is part of wider set of complimentary reforms on Adult Social Care and the Health and Care Bill which is currently being debated in Parliament.
The White Paper proposals aim to make integrated health and social care a reality for everyone across England, with a focus on place-based and population-level approaches to care and the introduction of a single person accountable for delivery of a shared plan at a local level.
The Paper explains that successful integration is the planning, commissioning and delivery of coordinated, joined up and seamless services to support people to live healthy independent and dignified lives and which improves outcomes for the population as a whole. It states that everyone should receive the right care, in the right place, at the right time – a phrase that will be familiar to readers.
There is an impassioned foreword by the Rt Hon Sajid Javid and Rt Hon Michael Gove. Clearly the lessons learned during the pandemic feature.
The executive summary (at pages 8-13) talks of a “decisive shift”, “mutually reinforcing reforms”, “engine for delivery”, “unlocking the power of data” and “making it a reality now”.
Specifically, this White Paper sets out commitments on:
- Designing shared outcomes, focused on person-centred care to begin from April 2023
- A formal place-based delivery model to be implemented by places by Spring 2023
- A robust regulatory system to support integrated care delivery at place-level
- Workforce, digital and data and financial pooling and alignment – described as the ‘key enablers of integration’ required to join up services. Below is a selection of the key commitments:
- A review of existing pooling arrangements between the NHS and local authorities under section 75 NHS Act 2006, with a view to simplifying the regulations for commissioners and providers.
- Shared care records by 2024.
- ICSs will develop ‘digital investment plans’ to bring all organisations to the same level of digital maturity, ensuring that data flows seamlessly across all care settings and use tech to transform care at place level.
- Formal recognition of Digital Data and Technology profession within the NHS Agenda for Change, including training in digital, data and technology skills together with supporting staff to be confident when recommending interventions to patients using services.
- ICSs to support joint health and care workforce planning at place-level working with both national and local organisations, including joint roles across health and social care.
- A single person, accountable at place level, for delivery of a shared care plan
The White Paper identifies key themes covering:
- ICSs and the importance of ‘place’
- Digital and data
- Social care
- Workforce flexibility
- Funding and more pooled budgets
Our follow up articles will look at the themes and next steps in more detail.
Questions for you
At the end of each chapter are a series of questions. These are then grouped together under themes at pages 67-69. Engagement with stakeholders is to start shortly.
Next steps and key dates
The policies outlined in this White Paper build on the proposals in the Health and Care Bill which are not expected to come into play until July 2022, subject to parliamentary process.
However, the expectation is that the following key commitments will happen in accordance with this published timeline. Specifically, 21 next steps are set out in chapter six and these include:
- 2022: engagement with stakeholders
- 2022: develop a standards roadmap and a suite of standards for adult social care by Autumn 2023
- Spring 2022: Dr Clare Fuller, CEO Surrey Heartlands ICS reporting on how systems can enable more integrated primary care at neighbourhood and place
- April 2023: implementation of shared outcomes
- Spring 2023: all places to adopt a place-level model of accountability
- Spring 2023: guidance to be published on pooled budgets
- Spring 2023: a set of front-runner areas to trial the outcomes, accountability, regulatory and financial reforms set out in the White Paper.
- By 2024: access to a single health and adult social care record
- By 2025: each ICS will implement a population health platform
Please do not hesitate to contact Jill Mason or Rhian Vandrill should you wish to discuss any of the issues raised here.
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