The NHS must be realistic about the pace of integration and what it can deliver

A new report by the National Audit Office (NAO) says the integration of health and social care has been slower and less successful than envisaged.

The document says the Better Care Fund has improved joint working but has not achieved its potential. Demand for services rose in its first year and the fund did not achieve planned savings.

The report warns that expectations for other initiatives including sustainability and transformation plans (STPs) and new models of care are over-optimistic.

Responding to the NAO’s report, the chief executive of NHS Providers, Chris Hopson said:

“NHS trusts have been at the forefront of efforts to integrate health and social care for patients and the public. This report rightly concludes that although there has been real progress, there is still a long way to go.

“As trusts like Tameside, Northumbria, Salford and Torbay have shown, integrating health and care services can rapidly improve health outcomes and patient experience. But it is telling that, despite nearly two decades of initiatives to join up health and social care, the NAO concludes there is still no compelling evidence to show this leads to long term financial savings or reduced hospital activity.

NHS trusts have been at the forefront of efforts to integrate health and social care for patients and the public

“On the Better Care Fund, the report echoes what NHS Providers has said since the fund's inception - that while it would help local health and care systems work together it was not, by itself, going to provide more integrated care for patients, widespread service improvement or significant savings. This is not surprising as one of the key drivers of the fund was to provide political cover for an overall reduction in the health and care budget.

“Trust leaders strongly support the idea of system based planning and the NHS Five year forward view vision of moving to new ways of providing care. But they agree with the NAO that expectations around STPs and new models of care are unrealistic. The NHS has to be more realistic about what savings can be delivered, how quickly.

“We have called for a new plan to take the NHS through the rest of this parliament, which addresses with absolute clarity the growing gap between what the NHS is expected to provide, and the resources available, including a realistic assessment of the pace of closer integration and what it can deliver.”

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