Health and social care ‘join up’ plans unveiled
Minister announces proposals to integrate services by 2018 to stop people being passed around hospital and social care staff
The government has announced plans for “joined-up” health and social care by 2018, potentially imposing a financial penalty on services if they ask patients to retell their stories to different layers of professionals.
Under the proposals unveiled by health minister Norman Lamb, hospitals would also be paid based on how patients rate their experiences.
The government has asked the regulator and NHS England to come up with a system that would stop people being passed around between doctors in hospitals and community services.
The government aims to “make joined-up and co-ordinated health and care the norm by 2018” – in effect stealing a march on Ed Miliband who has made integration the cornerstone of Labour’s health policy.
NHS England, the quango running the health service, will have a budget of about £1bn to ensure there are integrated projects in every part of the country by 2015.
Lamb said this would help end patients suffering disjointed care and support. In a recent study a third of bereaved people said hospitals did not work well with GPs and other services.
The government also pointed out that patients were facing long waits in hospital before being discharged, in part because of inadequate co-ordination between hospital and social care staff. Delayed discharges cost the NHS £370m a year.
Lamb said that “people are falling through the cracks”. He said that he wanted to end the fact that people are “having to retell their story every time they encounter a new service”.
“It’s a crisis point really,” he said. “People not getting the support they need because different parts of the system don’t talk to each other; older people discharged from hospital to homes not adapted to their needs, only to deteriorate or fall and end up back in A&E. Cutting emergency readmissions will bring a much better experience for patients.”
Chris Ham, chief executive of the King’s Fund, said the government’s announcement was a step change in the debate. “Feedback from our work with local health and social care leaders indicates that some aspects of current policy and regulation are acting as barriers to delivering co-ordinated care,” he said. “This should be addressed by giving pioneer areas freedom and flexibility to overcome these restrictions when they are rolled out from September.”
The coalition is attempting to mollify critics of its health policy who claim hospitals will have to compete with each other rather than co-operate to provide patient care. They point out that GPs buying treatment from the NHS’s flagship “joined-up hospital” – Torbay’s pioneering integrated health organisation – are taking legal advice amid fears they can no longer buy care directly because of a legal requirement to competitively tender some services.
Lamb said he had met Torbay to discuss the problem. “I don’t think these will be a barrier at all. We are looking to measure patient experience along a care journey and pay [hospitals] for it. It is a move forward.”
The idea of paying hospitals on the basis of patients’ ratings has been lifted from President Obama’s healthcare programme. In the United States nearly $1bn (£630m) in payments to hospitals a year will be based partly on patient satisfaction. Patients will fill in a 27-question government survey and US hospitals with high scores will get a bonus payment. Those with low ones will lose money