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Greater integration of health and social care services across England will need to be backed up by “significant” upfront investment and cannot in itself be relied upon to make savings in the short term, a major report by public finance experts warns.
The Chartered Institute of Public Finance and Accountancy (CIPFA) said the government must recognise that combining two “financially challenged systems” will need additional funding or changes to the regime for charging, while any benefits of integration may take some years to come through in full.
CIPFA said that the Government should set aside invest to save funding to enable costs of change and transition to be met without undermining the short-term position. The Government also needs to move quickly to address the financial and policy framework for integration in 2016-17 and beyond.
The report, Let’s Get Together: Integrating Health and Social Care [PDF] – launched at CIPFA’s Social Care and Health Conference - is the result of a nationwide consultation with 200 leading public finance experts and calls for a streamlining of services, with a much greater effort towards creating wellness and not just treating ill health.
CIPFA said that the promising start represented by the government’s £5.3 billion Better Care Fund to join up the NHS and council-run social care systems, the Greater Manchester and Cornwall devolution initiatives and pilots linked to the five-year forward plan for the NHS will be “dissipated” unless local health and social care providers are able to effectively budget for the medium term.
For their part, central and local health and social care leaders must take the right local actions to facilitate successful integration, concentrating on frontline practice and ensuring that their staff have the right attitudes, skills and knowledge to work collaboratively across organisational boundaries. They also need to invest in prevention and encourage people to take responsibility for looking after their own health.
Rob Whiteman, CEO of CIPFA, said:
“The status quo of providing separate health and social care services is no longer viable.
“Major financial challenges and demographic changes mean we cannot continue providing these services in silos if we are to lessen spending pressures and better manage future demand.
“So the priority has to be creating a more integrated health and social care system that meets people’s needs while providing long term financial sustainability.
“While there have been some promising policy initiatives to achieve this goal, the government needs to act quickly and recognise that integration should not be an end in itself and it should not become weighed down by bureaucratic rules and targets.
“Instead, the government must accept that there will be significant upfront transitional costs and encourage local services to work together, build community capacity, plan for the medium term and focus on prevention.
“By tackling emerging health and social care issues through a whole systems approach, we are far more likely to achieve a stable long-term financial position and ultimately better services and outcomes for the public.”
A copy of the report Let’s Get Together: Integrating Health and Social Care [PDF] is available online.
The Chartered Institute of Public Finance and Accountancy (CIPFA) is one of the leading professional accountancy bodies in the UK and the only one which specialises in the public services. It is responsible for the education and training of professional accountants and for their regulation through the setting and monitoring of professional standards.
Uniquely among the professional accountancy bodies in the UK, CIPFA has responsibility for setting accounting standards for a significant part of the economy, namely local government. CIPFA’s members work (often at the most senior level) in the public service bodies, in the national audit agencies and major accountancy firms. They are respected throughout for their high technical and ethical standards and professional integrity. CIPFA also provides a range of high quality advisory, information and training and consultancy services to public service organisations. As such, CIPFA is the leading independent commentator on managing and accounting for public money.
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