Title: Rebooting Health and Social Care Integration: An agenda for more person centred care

Author: Liam Booth-Smith

Published by: Localis

Date: July 2017

It’s hard to remember 10 years ago when very few people were talking about integration between health and social care. Then everyone was. The tide turned and suddenly we were flooded. Although still a live topic, it has felt of late as if the focus has shifted. Domination of other national topics has stemmed the flow. So I was interested when I saw this report from Localis.

Localis is an independent, not-for-profit think tank that promotes neo-localist ideas. Yes, ‘neo-localism’ was new to me too. Their definition is: “Neo-localism is about giving places and people more control over the effects of globalisation. It is concerned by economic prosperity, but also enhancing other aspects of people’s lives such as family and culture. It is not anti-globalisation, but wants to bend the mainstream of social and economic policy so that place is put at the centre of political thinking.”

They have a high volume research output covering a range of mainly public sector areas. This report, sponsored by Capita, is the culmination of six months’ work involving surveys, interviews, two practitioner roundtables, a literature review, data analysis and public polling conducted by YouGov.

The main messages

The overall message is that there remains a case for integration of health and social care if the focus moves away from structural change and financial drivers. Future integration should be about better co-ordination, more personalisation and the unlocking of social capital and innovation (page 10).

This makes a lot of sense and there is plenty of good analysis of experience to date, where frustrations have arisen and why things may have stalled. Alongside these are practical suggestions for the future.

The report makes a series of strategic and policy recommendations for government. Presumably, this is the audience the report seeks to influence. However, there are plenty of useful tips and ideas for those in local authorities and NHS organisations.

Highlights

• The author makes the valid point that a focus on the elderly is too narrow as demand and costs come from all age groups (page 15). This is a theme in my Twitter feed where people challenge the lazy thinking that says the demographic age change is the cause of all our problems. It is good to see figures that back this up.
• There is an emphasis throughout on better use of technology to improve co-ordination (pages 21-23) and mobile working, patient held records and telecare (pages 30-31). Our friends at Lambeth and Southwark get a mention for their Local Care Record. However, there was no mention of fully technology enabled services such as online GP services or SH:24, the sexual health service we featured recently. These are not about integration so the omission is understandable although a key theme of the report is greater independence and control for people.
• A system wide approach to training and shared professional development and networks are seen as a way to breakdown the health and social care culture divide (pages 23-25) with Canterbury New Zealand and Hackney and City Social Care Forum cited as examples. Maybe we can go further and say it does not just bridge a divide, it actively creates collaboration. Stockport Family have created a new strong collective way of working across several different agencies through a common development programme.
• The YouGov poll data shows a fascinating difference in attitudes to family care between voters of different political parties (page 34).

Summary

Overall, despite the sometimes heavy reading, this report does say something new for what is a much discussed topic. In my work on alliances and collaborations in public services, I have come to recognise that it is not the integration that matters, it is the change in mindset that comes from working alongside others with different ideas and perspectives. This report supports that.

Photo by Marion Michele