If Integration Is the Answer, What Was the Question? What next for English Health and Social Care Partnerships?

Abstract

Integrated care’ has been a key policy priority in English health and social care in recent years – although the extent to which this commitment is real rather than rhetorical remains open to debate. While everyone working in health and social care knows that single agency responses are insufficient when trying to support people with complex needs, there is a danger that ‘integrated care’ becomes a buzzword, apparently capable of resolving a range of different longstanding policy problems at once. This is particularly the case in a very challenging financial climate, when some policy makers appear to assume that this way of working will be able to dramatically improve outcomes whilst also significantly reducing costs. The paper suggests four fruitful approaches to integrated care: being very clear about the outcomes that partners are trying to deliver – without a shared sense of what success would look like, we can have no basis for deciding how best to design local joint working arrangements and no way of knowing if our chosen approach is working; successful joint working depends on working with different professional values and cultures; adult social care in England is currently embedding a ‘personalisation’ agenda, which includes giving people using services greater control over the care they receive via direct payments and personal budgets; local government (which is responsible for social care) and the NHS (responsible for health care) need each other now more than ever – the time may be right for a more fundamental reconsideration of the relationship between health and social care, rather than additional pilot projects and initiatives.