08.02.12
Elderly suffering from ‘fragmented’ services
Joined-up commissioning would secure better outcomes for older people, a new report on social care by the Commons Health Select Committee suggests.
The report urges Government to coordinate policy more effectively and regularly rebalance national spending to ensure quality services can be delivered.
Elderly people account for a large proportion of demand on the health and social care system, and with an ageing population, these challenges are set to increase. The elderly account for 50% of those in social housing, 70% of hospital beds and 91% of those who need nursing care. The committee suggests that providing elderly people with help at home can reduce hospital admissions by 30%.
The committee criticised the current system for its fragmented services, due to multiple funding streams and approaches to commissioning. They also argue that the money planned to be spent in this area, even though increasing is “not sufficient to maintain adequate levels of service quality” due to spiralling demand.
Chair of the committee, Stephen Dorrell MP, said: “It is impossible to deliver either high quality or efficient services when the patient is passed like a parcel from one part of the system to another, without any serious attempt to look at their needs in the round.
“The funding for NHS care, social care and social housing comes from different sources. Apart from a few exceptions like Torbay Care Trust in Devon, attempts to join up these funds and to integrate services have been disappointing.
“Our central recommendation is that the key to joined up services is joined up commissioning.”
The report suggests replacing the three frameworks of health, housing and care services with one based on outcomes, implementing a cap on care costs, identifying and assessing carers earlier and the development of a new, integrated legal framework.
NHS Confederation deputy policy director Jo Webber said: “Integrated health and social care systems are currently the exception rather than the norm. Pooled budgets, single commissioners and a single outcomes framework for older people could all help make health and social care work better for patients in more places.”
Lord Victor Adebowale, Turning Point’s chief executive and a member of NHE’s editorial board added: “The focus now must be on increasing the integration of services for everyone who needs them, particularly those with the most complex needs. When these needs aren’t addressed, people end up falling between the gaps in provision.
“Whilst efforts to progress integration have been taken forward, it is actually disappointing that we are still talking about health and social care as separate entities. The fact is that they are inextricably linked: not only in terms of spend, but also in terms of savings and where these are achieved.”
Dr Linda Patterson, clinical vice-president of the Royal College of Physicians, said:
“If there were better integration of health and social care services, people would be able to stay as long as possible in their own homes, living productive independent lives.”
The minister for care services, Paul Burstow, said: “We know that urgent reform of the care and support system is needed. Integrated care should be the norm. That’s why we asked the NHS Future Forum to specifically work on this issue.”
He stated that a Government response and full proposals for reform of adult social care would be forthcoming in the spring.
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