Will new integration fund be a catalyst or catastrophe?

‘Moving to integrated designs of care and pooling well being and social care budgets is the right course of travel’ says Chris Hopson. Photograph: Alex Segre/Alamy

The integration transformation fund, now the better care fund, could be either “a catastrophe or a catalyst”. The well being and social care technique badly requirements the latter but, to avoid the former, we must successfully control the considerable dangers that the fund creates.

Long term, moving to integrated models of care and pooling health and social care budgets is the correct path of travel.

The new £3.8bn fund seeks to pool existing budgets in 2015/sixteen to enable better integrated functioning and transformation of regional services to older and disabled folks. Local programs will be signed off by clinical commissioning groups (CCGs) and local authorities by means of overall health and wellbeing boards. The dangers are fourfold, driven by the present public spending squeeze:

• There is no new cash. The budgets from the two the NHS and social care are being taken from present services delivery and unless of course the new integrated designs of care supported by the fund provide instant equivalent benefit, the service to sufferers will be worse.

• There is double counting. Councils have been informed that, since the £3.8bn will be spent on regional authority providers, their paying energy is unaffected. The NHS has been informed that the NHS ringfence is maintained. These can’t each be correct – general funding across regional government and the NHS is considerably reduce.

• It truly is unusual that adjust to public sector delivery is attempted at this scale and pace without double working without having important investment in the new models and without having assurance that these new designs are operating effectively ahead of the old ones are turned off.

• Even though it is clear that integrated care versions generate far better outcomes for patients, the evidence that they are cheaper and far more effective stays unproven.

So how do we ensure the fund is a catalyst not a catastrophe?

one. Honesty on the scale of challenge
The fund can not compensate for social care funding cuts investment in new designs of integrated care and a diverse way of the NHS investing its health allocation. Central government is asking local wellness and social care economies to balance these competing priorities and offer much better, much more integrated, companies with much less income. This is a considerable challenge and pretending that it does not exist isn’t beneficial.

2. Support for a collaborative, partnership, organizing process
Some local well being and social care economies are properly integrated, have powerful collaborative relationships and are employed to arranging collectively. Feasible reactions to this process incorporate denial, division and disintegration: denial that it really is going to happen division as well being and social care fight more than scarce funds and disintegration as threatened services deliverers seek to protect their corner.

three. Identifying the risk to NHS service delivery
Taking £2.1bn out of mainstream NHS services delivery brings a quite significant chance. Sir David Nicholson told CCGs the fund will “require financial savings of in excess of £2bn in current spending … implying an added productivity achieve of two-3% across the NHS as a whole in 2015/sixteen … reflected in the tariff”. Provided the properly acknowledged problems in realising 4% savings a yr, leaping to 6-seven% is heroic.

Every nearby fund prepare demands to plainly identify the hazards to sufferers of moving this quantity of funds from existing delivery this quickly. NHS suppliers require to be concerned, not least due to the fact their potential to meet their performance targets will be affected. We then want a calm, sober, mature assessment of whether or not the risk of moving to new designs of care at this velocity and scale is manageable.

If all goes properly, we will seem back on the far better care fund in ten years’ time as a key phase to an integrated well being and social care system. But that will only happen if we effectively deal with the hazards that accompany the creation of the fund.

Chris Hopson is chief executive of the Foundation Trust Network

This article is published by Guardian Specialist. Join the Healthcare Professionals Network to obtain typical emails and unique gives.

Will new integration fund be a catalyst or catastrophe?