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Remove barriers to the integration of care before April 2018

So we will review the operation of the internal market and, in time for the start of the 2018 financial year, we will make non-legislative changes to remove barriers to the integration of care.

Our Verdict

The “integration of care” mentioned in this policy is a new model of healthcare delivery which seeks to meet increasing demands and changing needs by better coordinating existing care provision into a more coherent system.

NHS England tells us:

“In an integrated care system, NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve”.

The manifesto promises “non-legislative changes” before April 2018. Non-legislative changes do not require a change in the law. In this case, they could be any new arrangements and agreements within or between government, the NHS and other healthcare bodies.

In June 2018, the Health and Social Care Committee published a report on integrated care highlighting key action items, including the need to address legal barriers and fragmentation that arose out the Health and Social Care Act 2012, to facilitate greater integration of care. The government responded in August 2018, promising to “develop a national transformation strategy backed by secure long-term funding”.

Following that promise, the clearest evidence of action related to this policy pledge has been the publication, in January 2019, of the NHS Long Term Plan, a comprehensive strategy addressing the future of the NHS. A significant element of the Long Term Plan is the roll-out of Integrated Care Systems (ICSs), with the aim of “[bringing] together local organisations to redesign care and improve population health”.

The Long Term Plan represents a clear attempt to “remove barriers to the integration of care”, but the government’s own deadline for fulfilling this pledge was April 2018 and the Long Term Plan was published nine months after that. Whilst acknowledging progress towards the substantive goal of integrated care, missing their own deadline means we have to mark this as ‘broken’.

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