A critical juncture for integration

While the media spotlight is heavily focusing on health and social care, it is vital to incorporate ‘true integration’ into all services and areas – something all organisations need to take heed as the race to attract and retain staff becomes more competitive. Chris Barrow explains

Health and social care are at a critical point following the Prime Minister’s recent announcement of a National Insurance  hike, which will raise £36bn over the next three years. This includes a £5.4bn cash injection to the NHS to support the COVID-19 response over the next six months and £1bn to help tackle backlogs. While the extra funding is welcome, many feel the £5.4bn dedicated to social care will simply paper over the ever-growing cracks in what is ultimately a broken system. Some also argue that the Government’s care plan is NHS dominated and that past mistakes have not been learnt from.

Indeed, in his statement the PM stressed that: ‘We learned from the pandemic that we can’t fix the NHS unless we also fix social care.’ This was known long before COVID hit, and the social care sector’s loud and clear message over the years has ultimately fallen on deaf ears in Whitehall. Has it really taken a global pandemic for the Government to recognise the intrinsic interdependence of health and social care?

While the questions relating to the new bill continue to be widely debated, and rightly so, another of the PM’s announcements has gone somewhat under the radar – the arrival of the long awaited and eagerly anticipated integration White Paper. Due later this year, the paper will look to outline how health and social care can work together at a critical moment for the sector.

True integration between health and social care is crucial to support society’s most vulnerable residents and the future sustainability of the sector, and the risks of letting recent progress slip could have a devastating impact. Louise Inman, health integration policy lead at Surrey CC, warns that: ‘While much progress has been made in terms of health and social care integration nationally over the last 18 months, there is a significant risk that some of this good work could unravel. The NHS’s focus over the next three years will naturally be on clearing the elective backlog, and, while local government can help from a prevention angle, there is a real risk that the NHS will become consumed by this pressing need, to the detriment of a more community focused agenda.’

In Surrey, roles like Louise’s – plus joint appointments to the ICS executive, and senior adult social care staff on place-based partnership boards – are intended to mitigate that risk. 

It is of critical importance, therefore, that the health and care sector capitalises on some of the positive trends that have emerged from the pandemic, such as residents supporting each other in times of need and taking a more active role in their local communities. Local government must empower people to make decisions about their own lives, including about the care they receive, as well as supporting local organisations and voluntary groups to achieve greater impact and reach in their communities.

Funding can only go so far, and the infrastructure and support must be put in place to allow people to live independently in their own homes for as long as possible. This will also reduce pressure on the NHS. There must also be an increased role for digital technology to connect public services, enable a collaborative approach and achieve common goals. Indeed, this is expected to form a vital pillar of the White Paper’s recommendations. 

While the media spotlight is shining brightly on health and social care, isolating the integration agenda to just these areas is missing the point. It’s about all public services, every touch point with people’s lives. Areas such as housing, welfare, and debt, for example, will become increasingly important and pressurised as the economy reels from the impact of the pandemic, the true extent of which remains to be seen.

The impact of true integration on the workforce has been, and will continue to be, significant. We have seen a move towards more joint posts and working outside of traditional organisational boundaries; trends only set to continue. Agile working and homeworking are here to stay and must be embraced by the sector wherever possible, or it is at risk of being left behind. Councils must continue to put staff wellbeing at the forefront of the agenda and not allow it to be shelved post-pandemic.

The full impact of COVID on the recruitment and retention of staff remains to be seen but severe staff shortages are likely to continue. It is more important than ever that organisations take concrete steps to improve how they attract and retain staff, through attractive pay offers, opportunities for flexible working and clearer career pathways.

Ultimately local government and the sector’s partners need to be brave and bold in their decision making. They must build strong relationships and take a human approach to integration. We have a once in a lifetime opportunity to get it right, learn the lessons from the past 18 months and improve the lives of some of the most vulnerable in our society. n

Chris Barrow is senior consultant at Tile Hill