The Government’s white paper on health and care is a further forward step the integration of our systems to support people at their most vulnerable, sweeping away the Coalition Government reforms from 2012. Whilst it is clear the gains that integration will bring to individuals, families and communities as well as supporting siloed systems to work better together, these proposals should not be seen as a fix to the fragile social care system and its impact on the wider determinants of our lives. The Government must reform social care in order for integration to be successful.
Health and Social care work at their best collectively, they have always been part of the same system and the pandemic and the level of growing complex needs in our society, has highlighted the importance of this now more than ever. An integrated system will enable providers and services to work collaboratively and form dynamic partnerships to improve care for individuals and address wider community level health problems. The Governments new white paper on health and care ,alongside NHSE Improvement’s paper on integration, have sought to put Integrated Care Systems on a statutory footing as well as committing to bringing forward social care reform later this year.
Far too often people suffer the effects of a fragmented health and care system. It is therefore difficult to argue against the improved integration of services across health and social care which has the potential to improve people’s outcomes particularly for those in contact with different services like the many working age disabled adults we support at The Disabilities Trust.
The Disabilities Trust, therefore welcomes the proposed structural reforms put forward by the Government. However it is important to recognise the limitations of what legislative change can achieve alone. Critical elements of a strong integrated system include trust, partnership, good leadership and effective working practices all of which require cultural change and remain untouched by legislative process. The success of this will be in how this cultural change will be supported and communicated to ensure real collaboration across organisational and professional boundaries.
As we have raised before the health and social care sector faces significant workforce issue in terms of recruitment and retention and we need an urgent long term, sustainable plan for social reform. Without reform which addresses these long standing challenges we risk the success of integration due to the fundamental fault line caused by unstainable funding structures in social care. From regulation to commissioning, funding and staffing we need reform but I believe there are opportunities to shape a more sustainable future for the social care system.
Covid-19 has undoubtedly increased the profile of social care however this has been focused on only certain parts of the sector. There is a risk that this raised awareness focuses reform through a specific lens based on older people and institution to the exclusion of working age disabled adults.
This moment of reform must be grasped to ensure that our health and care systems enable all to live their best lives and receive the right support at the right time.