The key to securing better outcomes for older people and other vulnerable groups, and to delivering the required efficiency savings for the NHS is joined up services, say MPs on the Health Select Committee.
The Health Committee looked at the issues facing the future of social care and concluded that joined up services are crucial to meeting the needs of older people. It is impossible to deliver either high quality or efficient services when the patient is passed like a parcel from one part of the system to another, without any serious attempt to look at their needs in the round. While this is an obvious truth and has often been repeated, it is seldom acted upon.
The Committee found that the way healthcare is funded is a major barrier to improvement. The funding for NHS care, social care and social housing comes from different sources and attempts to join up these funds and to integrate services have been disappointing.
The Committee recommends that there should be joined up commissioning. The Government should place a duty on the new clinical commissioning groups and local councils to create a single commissioning process, with a single accounting officer, and a single outcomes framework for older people’s health, care and housing services in their area.
This would improve outcomes by making it easier to move money around the local health, housing and social care system. It will also play a significant part in delivering the Nicholson Challenge for the NHS of 4% efficiency saving every year over the next four years.
Growing demand, coupled with an unprecedented efficiency challenge, makes it more urgent than ever before to respond to the challenge of joining up services. The Committee looks to the Government to set out in its Social Care White Paper how this vital objective will be met.
The Committee’s recommendation for joint commissioning of services is supported by evidence presented to them by the Torbay Strategic Partnership which developed their approach with a grant of £250k from the Regional Improvement & Effiecient Programme to take forward the Total Place methodology. Total Place has now evolved into the Community Budgets initiative where pilot projects are bringing together all funding on local public services from the area into a single pot and allowing multi skilled teams to work across organisational boundaries to find innovative solutions. Torbay has demonstrated that their approach provides a better service at a lower cost.
The Committee’s report will provide a boost to Community Budgets, but it has also revealed that the Department of Health has little enthusiasm for moving control of budgets from Whitehall to allow spending decisions to be taken locally. Care Services Minister Paul Burstow told the Committee that he sees Care Trusts (such as Torbay) as “an experiment that […] did not really get out of the lab”.