The new ‘joint commissioning’ funding outlined in the Comprehensive Spending Review was described by Health Secretary Jeremy Hunt as a major step towards integrated care.
However, coming together with a 10% cut in local government resource budgets, it will primarily serve to shore up cash-deprived social care services.
The NHS already transfers £1bn of its annual budget to social care, and this will rise to £3.4bn in 2015–16, combining with Government grants to create a £3.8bn ‘joint commissioning’ fund.
In order to access this fund, social services will need to provide seven-day care and work together with CCGs.
Every person cared for under this funding will need to have an ‘accountable clinician’, normally their GP. The new system will serve primarily to improve the continuity of care for vulnerable elderly patients.
Hunt claimed the new fund was “a huge moment in the NHS’s history” that would “restore clinical accountability outside hospitals”.
“In order to access the £3bn pot local councils and CCGs will have to do joint commissioning for vulnerable older people,” he said, implying that direct care provision is not necessarily part of the picture.
The new NHS ‘accountable care’ organisations could be similar to the US private healthcare company Kaiser Permanente, he added.
Plans for integrated care will need to be developed by CCGs and HWBs and signed off by Health Minister Norman Lamb.
Hunt added: “The integration pilots announced by Norman Lamb are going to be very significant. We want to create space for innovation.”
A key aspect of the new system, he suggested, would be “better clinical care of people in residential care homes”.
However, the new integrated care plans apply in a context of cuts on both sides. The NHS continues to face the ‘Nicholson challenge’ of a £5bn absolute (though formally undeclared) cut in its budget each year, while social care will be affected by a 10% cut in local government funding.
Sandie Keene, President of the Association of Directors of Social Services, said: “The benefits gained from closer integration with the services provided by our health colleagues will be rendered less valuable if the intricate relationship with other services is threatened by severe downward pressures on local government as a whole.”