As pressure on health services around the country increase and budget cuts continue, concerns have been raised about how health and social care will remain sustainable into the future as the population ages. Promises have been made to prioritise health and social care spending – but are these promises realistic? At CIPFA’s Health and Social Care conference in October, ‘Insights into Integration’, we were able to discuss these issues through the broad lens of the integration agenda.
Conversations about integration are nothing new, and we continue to debate how to make it work effectively. Siva Anandaciva, chief analyst at the King’s Fund, opened our conference by raising an important question - how do we make the money work for integration? We can all agree that the general public is living longer in poor health, and that demand is increasing each year beyond the resources available to meet it. While place-based, integrated health and social care services may alleviate some of this pressure, how can we deliver on this agenda when the funding pots remain siloed?
Richard Gleave from Public Health England highlighted the need for an increased focus on prevention, while Anita Charlesworth from the Health Foundation brought in the problem of social care funding in an age of budget cuts, staff shortages and uncertainty. Finally, Nick Davies from the Institute for Government used the latest Performance Tracker to highlight how health and social care services have faced both a reduction in funding and quality over time.
Together, this created a complex picture in which political rhetoric is leaning towards integration, but in which resource is neither sufficient in quantity nor appropriately structured to achieve it. We have yet to see measures that address the practical finance and governance challenges presented by the overall ambition.
The ’Insights into Integration’ conference highlighted the tipping point we have reached. The speakers we had the pleasure of welcoming demonstrated beyond a shadow of a doubt that action on integration is needed now more than ever. CIPFA’s broader wish list also includes a renewed focus on place-based care, a funding solution for social care and improvements to NHS infrastructure.
As we now have a new government, and move into a new decade, we would hope that these discussions are put at the heart of policy decisions.