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Health and social care to be integrated by 2018, why aren't they already?

View profile for Mike Pemberton
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Today the BBC and news agencies report that Ministers are promising an end to the era of vulnerable people being passed around the health and care systems.

The pledge forms part of a shared commitment being set out by NHS and local government leaders to close the gap between the two systems by 2018. A series of pioneer projects will be launched in the Autumn. These will explore new ways of pooling NHS and Local Authority budgets, speeding up discharge from hospitals and streamlining assessments.

The commitment has been signed up to by the Department of Health, NHS England, the Local Government Association and the umbrella bodies for directors of child and adult social care.

Care and support minister Norman Lamb said: "People don't want health care or social care, they just want the best care. This is a vital step in creating a truly joined up system that puts people first. Unless we change the way we work, the NHS and care system is heading for a crisis."

"The whole thing is co-ordinated in the patient's interest... it's not rocket science"

Local Government Association chairman Sir Merrick Cockell said "Councils have a key role to play in integrating services to both improve the quality of care and support that people receive and help find new ways of addressing the long-standing concerns around the future funding of care services."

However, what this initiative fails to recognise fully are the existing duties on both Health and Social Care to integrate and provide/arrange necessary services to meet the needs of the vulnerable and disabled. It also comes as figures show elderly hospital patients are already facing increasing delays for social care help.

Last week directors of local authority social services warned that their budgets were likely to be reduced again this year - on top of the two years of cuts already seen. Is this initiative anything more than words?

We have seen numerous policy statements, initiatives and sound bites released by the government over the last 12 months and more. What they have in common is an apparent realisation of the problems in the system…but no increase of resources or funding to meet the challenges the system has always faced and is increasingly facing as time marches forwards.

My own view is fairly simple – the more that the country wishes for its health and social care systems to improve and to integrate, the more demand there is likely to be. A person at home struggling to provide care to a family member needs help now. The promise of an integrated future in 2018 is not going to help now.

Only yesterday the Local Government Ombudsman decided yet another case where a Local Authority failed to meet its existing duties to a disabled woman and her carer. Over a two year period the council failed to assess her properly and failed to provide sufficient help to her husband to look after her. The council was asked to pay over £60,000 in compensation to offset the losses in care that should have been made available to the couple had the council acted as it should have done. The money was meant to reflect the fact that the carer was forced to give up a promising career to look after his wife leading to poverty, illness and lost pensions for the future.

The government states that working for a living has to be preferable to a life on benefits. Most would agree. I suspect that most carers would also agree…if they had the chance.

Unfortunately, because the care system appears to let down so many so often, many are forced to simply live on benefits and give up work because the state assumes routinely that informal care (care from families etc) should count when identifying what help should be provided.

To some degree this is only right – most families would expect and want to provide care – but there are limits and help from care being provided by the NHS and Local Authorities can often mean the difference between managing to juggle a normal working life and not – with all that comes with the loss of dignity, income and opportunity in work.

Additional support to carers and the cared for is neither cheap, nor is it simple. Integrating Health and Social Care services is clearly a good idea – but it is not the whole solution.

By Community Care Advisor, Pete Donohue

Stephensons has a long history of expertise in the field of community care law and has experts in adult care provision, child care, and care funding matters.

We have been involved in a number of important cases in this field. Such services are a duty of the Authorities to provide to persons with eligible and assessed needs, such as the disabled, vulnerable children or the elderly.

Legal Aid may be available, or we have a competitive tariff of fixed fee options to assist people in legal matters in this field.

Our community care team is part of a larger public law and civil liberties Unit whose remit is to fight for the vulnerable, the underdog in their dealings with these large government bodies.

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