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Interface between health and adult social care

Sixty-Third Report of Session 2017–19

There is widespread consensus that integration and joint working is the right way forward for the health and social care system to deliver the best and most effective outcomes for people and their families. Financial pressures and an ageing population have increased the need for joined-up working, with local authorities reducing realterms spending on adult social care by 5.3% between 2010–11 and 2016–17, while the number of people in England aged 85 and over rose by 28% between 2006 and 2016. There are examples across England where integrated working has been successfully applied. But it is a long way from being in place everywhere, with a range of longstanding legal, structural and cultural barriers hindering the pace and scale at which change can happen.

There has been a lot of discussion within government over how to support and accelerate the integration of health and social care. In the past 20 years alone, there have been 12 white papers, green papers and consultations, and five independent reviews and consultations. However, the government still lacks an effective overall strategy or plan to achieve its long-held aim to integrate these two sectors. The renaming of a Government department is a sign of intent but with local authorities squeezed (as the Committee made clear in our report on the financial sustainability of local authorities) there is no realistic prospect of progress. Without this progress, people are at risk of not getting the joined-up, co-ordinated care they need, which could lead to poorer outcomes.