Effective engagement between integrated care systems (ICSs) and the adult social care sector (ASC) has not been consistent, research outlined in a white paper has concluded.
Through interviews with ICS leaders and care providers across the country, as well as a virtual roundtable event, the Good Governance Institute, Care England and the Homecare Association explored the extent to which the sector was being engaged with in the ongoing development of ICSs.
‘From our research for this report, it is evident there is a very clear divide in terms of perceptions of the NHS and the ASC sector,’ the white paper said. ‘This is primarily due to the difference in economic models of the two systems.
‘Overall, we found that very few ICS leaders knew much about social care at all. This is reflected by social care often being treated as an afterthought compared to the rest of the health and social care system.’
ICSs are being created to deliver joined up care, so people accessing services experience them as seamlessly as possible. Integrated care boards will be established as part of legislation for the introduction of ICSs. There are plans for 42 boards on 1 July.
The paper said it was critical social care had a seat at the table in ICSs from the outset, as this would help ensure a ‘dramatic improvement’ in terms of sustainability of the sector. It added inclusion would give the sector a louder voice when establishing guidance and when financial decision-making and resource allocation was discussed.
‘Many ICS leads are in consistent dialogue with representatives from local authorities, who have statutory responsibilities to deliver ASC and have made improvement in the sector a priority. One of the dangers of ICSs talking only to local authorities, however, is that the needs of people paying for their own care are overlooked,’ the document said.
Interviews as part of the white paper were carried out in August and included ICSs covering Bedfordshire, Luton and Milton Keynes; Black Country and West Birmingham; Dorset; Kent and Medway; Mid and South Essex; and North East London. Care providers included Bluebird Care, City & County Healthcare, Four Seasons, Lodge Group, and the National Care Group.
The white paper said although the profile of the ASC sector had grown recently, there remained a lot to be done. ‘In fact, in some places, the sector continues to teeter on the edge of implosion,’ it said. ‘Nonetheless, there is an opportunity for ICSs to work with ASC providers and commissioners to develop plans to secure the sustainability of services in their area.’
Andrew Corbett-Nolan, Good Governance Institute chief executive, said: ‘Engagement with adult social care is essential to the success of integrated care systems and the development of health and social care services. This paper and comes at an essential time for engagement with key partners across the system, to enable connections between health and social care.’
Recommendations included ICSs working with providers to develop more effective engagement mechanisms; developing a plan about how to engage with ASC providers and involving them in the process; and having a provider forum or liaising with local care associations that nominates a representative to a ICS partnership board.
It also called for the Department of Health and Social Care to publish a framework for ICS engagement with the sector.
The government is providing additional funding for social care of £5.4bn over three years to be spent on reforms. However, the paper said as well funding workforce issues around retention, career progression, staff skills and the quality of training persisted.
‘These issues have had a grave impact on the sustainability and the quality of service provided in the ASC sector. If this is not dealt with by ICSs as a priority, tens of thousands of vulnerable people could be left without access to the care they need,’ the paper said.
Professor Martin Green, Care England CEO, said: ‘In order for ICSs to succeed, social care provider’s must be heard. We urge all ICS leaders to carefully consider the key recommendations in this paper to ensure that integration works for both health and social care.’
Dr Jane Townson, Homecare Association CEO, added: ‘People receiving services need to experience seamless support from professionals and volunteers. It is therefore paramount to create a culture of collaboration between partners, focused on meeting the needs of people living at home.
‘We thus strongly encourage ICSs to engage effectively with homecare providers and develop the huge potential that joined up care systems offer. Investing in multi-disciplinary support for people to maintain their health and well-being at home helps to enhance healthy life expectancy, which benefits individuals and their families, reduces pressure on the NHS and reduces costs in health and care systems.’