National Audit Office reports on the health and social care interface
The National Audit Office (NAO) has published a report assessing the challenges preventing health and social care from working together effectively.
In a move to encourage the Government to create a long-term plan for a sustainable, joined-up care sector, the head of the NAO, Amyas Morse, has urged further and faster progress towards a service that centres on the needs of individuals, meets growing demands for care and delivers value to the taxpayer.
“No one across government or the civil service would disagree that health and social care have to be in balance to give people quality of life, and to use the available national and local resources as efficiently as possible,” said Mr Morse.
“The hard part is agreeing how that balance is to be achieved and maintained, and who is willing to sacrifice what to bring it about.
“The NHS did not like funds being syphoned off through the better care fund, whilst local government has reservations about sacrificing over half of its financial resources towards NHS England’s priorities, which risks eroding local democracy. The answer may lie in local flexibility, but that could leave serious gaps in delivering what is needed – an integrated service. Serious political leadership is needed.”
The report anticipates the Green Paper on the future funding of adult social care, now delayed until the autumn, and the planned 2019 Spending Review, which will set out funding allocations for both health and local government. It also acknowledges the Government’s recent announcement of funding increases for the NHS up to 2023-24.
The report finds that the financial pressure that the NHS and local government are under makes closer working between them difficult and can divert them from focusing on efforts to transform services. Short-term funding arrangements and uncertainty about future funding make it more difficult for health and social care organisations to plan effectively.
Although the report acknowledges the recent announcement of extra funding for the NHS, additional funding has, at times, been used to address financial pressures, rather than to make essential changes to services or adopt new technologies.
The report makes it clear that the NHS and local authorities operate in very different ways, and both sides can have a poor understanding of how decisions are made. Problems with sharing data across health and social care can prevent an individual’s care from being coordinated smoothly. The NAO report says new job roles and new ways of working could help to support person-centred care, but it is difficult to develop these because of the divide between health and social care workforces. A joint workforce strategy is currently in development. With social care now accounting for more than half of local authorities’ overall spending, the NAO says it is vital that the NHS and local government work effectively together to support person-centred care.