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Government response to the recommendations of the Health and Social Care Committee’s inquiry into ‘Integrated care: organisations, partnerships and systems’

Seventh report of session 2017-19

On 11 June 2018, the House of Commons Health and Social Care Committee published its report Integrated care: organisations, partnerships and systems. The report included 42 conclusions and recommendations, and responses to each of these are provided here.

The Committee launched this inquiry to examine the development of the new integrated ways of planning and delivering local health and care services which have arisen out of the NHS Five Year Forward View.

As we live longer and more of us develop complex, long term medical conditions, it is increasingly important that NHS services work together with each other and social care to ensure we get the support we need to stay well.

For many years, the health and care system has been grappling with the challenge of how to bring different organisations closer together, and the 2012 Act created a range of duties, on a variety of bodies, to promote integration across health and care. Through initiatives like the Government’s Better Care Fund and NHS England’s Vanguards programme, there has been a major drive to build stronger partnerships between the different bodies involved in our health and care.

Sustainability and Transformation Partnerships (STPs) – and, in their more mature form, Integrated Care Systems– are ways of promoting collaboration between NHS bodies and local government and local communities across whole systems. They are also vehicles for spreading the integrated care models developed and tested through the vanguard programme.

Integrated care is centred around a person’s needs; proactive in supporting wellbeing and identifying risks of health deteriorating; and coordinated so that it feels like it’s provided by one service, even if it isn’t. It should improve health and wellbeing for the population, enhance the quality of care from providers, and improve financial sustainability. Integrated care also involves a greater focus on population health. This will need the NHS, local authorities and the third sector to work together to enable the development of new models of care that focus on populations and their needs and, prevent ill health and unnecessary hospitalisation.

In some areas, commissioners are looking to strengthen integration by bringing together a range of health and care services under a single contract, with the provider of those services becoming an ‘Integrated Care Provider’ (or ‘ICP’ – previously referred to as an ‘accountable care organisation’) that is responsible for both quality of care and health outcomes for a defined population. We have changed our terminology in recognition that, as reported by the House of Commons Health and Social Care Committee, use of the term ‘accountable care’ has generated unwarranted misunderstanding about what is being proposed. We believe that the term ‘Integrated Care Provider’ better describes our proposals – to promote integrated service provision through a contract to be held by a single lead provider.

To support the NHS to deliver for patients across the country, the Government has announced a new five-year budget settlement for the NHS, which will see funding grow on average by 3.4% each year to 2023/24. This will mean the NHS budget will increase by over £20 billion compared with today. This additional funding will underpin a ten-year plan to guarantee the future of the NHS for the long term.

Ahead of the NHS plan publication in the autumn, we welcome the Committee’s timely conclusion that integration is the right direction of travel. However, we agree there is more to do to communicate this in a way that is meaningful for patients, staff and other stakeholders. We expect that the current public consultation on contracting arrangements for integrated care providers and the engagement process on the NHS long term plan will advance conversations with the public about the changes across the health and care sector.

We also welcome the Committee’s recognition that integration will not lead to privatisation nor will it threaten the founding principles of the NHS – which will always remain free at the point of use.