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NHS England introduces Integrated Personal Commissioning

Health and social care leaders have been invited to help build a new Integrated Personal Commissioning approach for people with complex care needs. 

Proposed by NHS England, the Local Government Association, the charitable personalised care consortium Think Local Act Personal and the Association of Directors of Adult Social Services (ADASS), the IPC is aimed at offering ‘power’ and ‘improved support’ to shape and commission care that is meaningful to individuals across the country. 

For example, local authorities, NHS commissioners and care providers will be offered dedicated technical support, coupled with regulatory and financial flexibilities to enable integration. The voluntary sector will also be a key partner in designing effective approaches, supporting individuals and driving cultural change. 

There are three goals for the IPC programme to improve the lives of key groups with significant health and social care needs. These are: 

• People with complex needs and their carers will have a better quality of life and can achieve the outcomes that are important to them and their families through greater involvement in their care, and being able to design support around their needs and circumstances.
• Prevention of crises in people’s lives that lead to unplanned hospital and institutional care by keeping them well and supporting self-management as measured by tools such as ‘patient activation’  – so ensuring better value for money.
• Better integration and quality of care, including better user and family experience of care. 

Earlier this year, Simon Stevens, chief executive of NHS England, in a speech at the Local Government Association annual conference, stated that the NHS would work to develop a people-powered commissioning programme in partnership with local authorities and the voluntary sector. 

Since then NHS England has worked with its partners to outline proposals for IPC, which is for those areas who share an ambition to “make change happen at pace for key groups with significant health and social care needs”. 

Under the proposals, the IPC financial model attempts to shift incentives towards prevention and coordination of care, by testing an integrated capitated payment approach. 

According to NHS England, the attraction of a capitated payment is that it can align financial accountability and the outcomes that matter to people. It added that current financial models can tend to reward NHS and social care activity and crisis services. “With capitation, providers have a much stronger incentive to proactively understand who is at risk, and take early action to prevent deterioration and coordinate services, which, to be effective involves working in partnership with the patient and their carer.”

The IPC announcement comes as the Barker Commission has called for a radical reshaping of health and social care delivery in England, which includes the introduction of a single, ring-fenced budget for the NHS and social care. 

NHS England boss Simon Stevens said:  “Kate Barker and the King’s Fund commission has today rightly described the need for more integrated health and social care for people who need care and their families. 

“While the longer term debate on how we get there is crucially important, so too is the need to deliver for people today. That’s why, for the first time since 1948, from next year IPC means we will start offering fully combined health and social care funding, under the direct control of people using those services.” 

The IPC programme will run for a minimum of three years beginning in April 2015. Sites applying to be part of the programme will need to have person-centred planning support and personal health budgets in place (beyond continuing care) from April 2015, and they will also be expected to contribute to a national evaluation. 

The closing date for IPC applications is 7 November 2014. They must be made jointly by one or more clinical commissioning group and local authorities, with at least one voluntary sector partner. In addition, local partners are expected to make a clear commitment to implementing new integrated funding models, making information and support available to their target population, and embedding personalisation in their organisations. 

ADASS president David Pearson said: “We have very much valued the opportunity to contribute to this immensely important initiative which will see personal budgets and Direct Payments – both of which an integral part of the social care offer in recent times - take a massive, decisive and encouraging step forward.” 

To see the prospectus in full, click here. 

(Top image is copyright National Voices, whose work on the non-personalised ‘webs of care’ has helped push the health and care system towards more integration and less fragmentation) 

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