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Published 11 February 2022
As the Health and Care Bill goes through the final stages in the House of Lords, and the White Paper on social care has very recently landed, the government has now published a new separate White Paper seeking to chart a path towards a more joined-up health and social care system - ‘Joining up care for people, places and populations’.
The proposals build on the foundations laid in the Health and Care Bill and centre around:
We look at what is being proposed and what to expect next.
What is being proposed?
The government is keen to make integrated health and social care a reality, pushing to go ‘further, faster’ towards that goal. This White Paper is seen as a further step in the ‘journey of reform’ towards achieving this.
Shared outcomes and governance at ‘place’ level
The government says that, in Spring 2023, it also plans to appoint a set of ‘front runner’ areas to trial these reforms.
The White Paper envisages a future where data flows seamlessly across all care settings. Whilst we are currently a long way off that, the government is keen to ensure that we harness digital advances to make sure this happens.
A key element of this is the plan for each ICS to ensure that, by 2024, everyone has a single health and care record, which all health and/or social care professionals they come into contact with can access (reiterating a commitment also made in the government’s draft data strategy, the final version of which is due to be published soon).
The wider sharing of data between providers across health and social care is also seen as essential to the integration agenda, including by helping ‘place boards’ (or their equivalents) and ICSs to plan and deliver shared outcomes. To support this, the government proposes to establish a set of standards to enable providers across the NHS and social care to share information with one another. This will sit alongside the Health and Care Bill proposal to create a statutory duty on organisations within the health and social care system to share anonymous data. As a next step, the government will also be expecting each ICS, by 2025, to implement a population health platform, with care coordination functionality, that will use joined-up data to support planning and proactive population health management.
The White Paper also looks at how to push forward with the digitalisation of all care records, with the government saying it will take an ‘ICS first’ approach on this, which will include encouraging organisations within each ICS to use the same digital systems and expecting ICSs to work with partners to drive adoption of digital records across health and social care.
Another important strand of the government’s vision for more joined-up health and social care provision, is to create a workforce that is properly supported to provide an integrated service.
With this in mind, the government says it will review the regulatory and statutory requirements that currently stand in the way of health and social care staff working flexibly across settings. It also plans to work with stakeholders to develop/test joint roles in health and social care, as well as considering the introduction of an Integrated Skills Passport that would enable staff to transfer skills and knowledge between the NHS, public health and social care.
To deliver shared outcomes, the White Paper says local leaders will need to think about what workforce integration looks like in their area, including who needs to be involved in shaping this and the practical steps required. Various examples of models to help implement this at place level are given, such as creating multi-disciplinary teams, physical co-location of staff or using a nominated key worker model.
These White Paper plans to create a more seamless health and social care system are inextricably linked with the Health and Care Bill proposals for restructuring the NHS, which are still going through Parliament and are not now expected to come into effect until July 2022 at the earliest.
Assuming that legislation goes through as planned, the steps this White Paper is proposing will follow thereafter, with key elements of this due to happen in line with the timescales below:
As the dust starts to settle on the form of the Health and Care Bill, and ICSs commence work on their proposed governance arrangements, it would be sensible for that governance design to factor in place-level governance models as a key pillar in those arrangements, in order to future-proof such arrangements as far as possible.
For more information, or to discuss the implications of this White Paper, please contact: Hamza Drabu, Charlotte Burnett, Alistair Robertson or David Hill.
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