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Health and social care plans behind target amid service pressures, says report

Plans to integrate health and social care services by 2020 have been slower and less successful than envisaged, a report finds. But the National Audit Office notes local areas have improved joint working.

Plans to integrate health and social care in England by 2020 are at significant risk as services struggle with existing pressures.

A new report by the National Audit Office says plans have been slower and less successful than envisaged and lessons should be learned from over-optimism when implementing larger scale changes.

It acknowledges the Better Care Fund, the principle driver to improve links between health and social care, has made progress in joint working.

Fund failings

But the NAO says the fund has not achieved the expected value for money from its 5.3 billion budget for 2015-16 in terms of savings, patient outcomes and reduced hospital activity.

The fund failed

Plans to integrate health and social care in England by 2020 are at ‘significant risk’ as services struggle with existing pressures.


The integrating health and social care plan has been slower than expected
Picture: Alamy

A new report by the  National Audit Office says plans have been slower and less successful than envisaged – and lessons should be learned from ‘over-optimism’ when implementing larger scale changes.

It acknowledges the Better Care Fund, the principle driver to improve links between health and social care, has made progress in joint working.

Fund failings

But the NAO says the fund has not achieved the expected value for money from its £5.3 billion budget for 2015-16 in terms of savings, patient outcomes and reduced hospital activity.

The fund failed to meet the following targets for its first year:

  • Save £511 million.
  • Reduce emergency admission by 106,000 – instead they increased by 87,000, costing £311 million more than planned.
  • Reduce delayed transfers by 293,000 – they, in fact, rose by 183,000, costing £146 million more than planned.

But the NAO report notes that 90% of local areas report the vision has led to better joint working. This has helped to reduce the permanent admissions of people over 65 to residential and nursing care homes.

'Significant challenge'

NAO comptroller and auditor general Amyas Morse said: ‘Integrating the health and social care sectors is a significant challenge in normal times, let alone times when both sectors are under pressure.

‘So far, benefits have fallen short of plans, despite much effort. It will be important to learn from the over-optimism of such plans when implementing the much larger NHS sustainability and transformation plans.’

Association of Directors of Adult Social Services president-elect Margaret Willcox said: ‘Integration is not the answer to improving social care, but should be seen as the means to an end to transform services to provide better coordinated care for people who need it.’

She added: ‘The NHS can only be protected if social care is protected too and the case for a single, shared and sustainable funding settlement is overwhelming.’

A Department of Health spokesperson said: 'The Better Care Fund is just one element of this government's programme to integrate health and social care for the first time – and as the report recognises, it has already incentivised local areas to work together better, with nine out of ten places saying their plans are improving services for patients.

'We will build on this for the future in making care even more joined-up.'


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