Integration and Innovation: working together to improve health and social care for all

The government has published a White Paper, ‘Integration and Innovation: working together to improve health and social care for all’, that sets out proposals to join up health and care services and embed lessons learned from the coronavirus (COVID-19) pandemic for a Health and Care Bill. Could part of a new integrated care system in England look like the arrangements in Wales, Scotland and Northern Ireland?

The paper is not the long-awaited social care White Paper which is expected later this year but a package of stated measures seek to make integrated care the default, reduce legal bureaucracy, and better support social care, public health and the NHS.

The reforms are intended to better enable the health and care sector to use technology in a modern way, establish a better platform to support staff and patient care, for example by improving the quality and availability of data across the health and care sector to enable systems to plan for the future care of their communities. It is interesting to note that housing there are only a couple of references to housing, primarily in relation to building partnerships, perhaps under the new duty to collaborate.

However, the measures proposed include:

• The NHS and local government to come together legally as part of integrated care systems to plan health and care services around their patients’ needs, and quickly implement innovative solutions to problems which would normally take years to fix, including moving services out of hospitals and into the community, focusing on preventative healthcare
• NHS staff currently waste a significant amount of time on unnecessary tendering processes for healthcare services. Under tthe proposals, the NHS will only need to tender services when it has the potential to lead to better outcomes for patients. This will mean staff can spend more time on patients and providing care, and local NHS services will have more power to act in the best interests of their communities
• The safety of patients is at the heart of NHS services. The upcoming bill will put the Healthcare Safety Investigations Branch permanently into law as a statutory body so it can continue to reduce risk and improve safety. The Healthcare Safety Investigations Branch already investigates when things go wrong without blaming people, so that mistakes can be learned from, and this strengthens its legal footing
• A package of measures to deliver on specific needs in the social care sector. This will improve oversight and accountability in the delivery of services through new assurance and data sharing measures in social care, update the legal framework to enable person-centred models of hospital discharge, and introduce improved powers for the Secretary of State to directly make payments to adult social care providers where required
• The COVID-19 pandemic has shown the impact of inequalities on public health outcomes and the need for government to act to help level up health across the country. Legislation will help to support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed.