Greater support for integration ‘urgently needed’

  • By Gemma Kappala-R...

London Councils is calling on government to help smooth the path towards further health and social care integration in London.

Ahead of the Autumn Statement, the membership body representing the 32 London boroughs and the City of London is presenting a package of integration asks to government. 

These wide-ranging proposals include strengthening the role of Health and Wellbeing Boards so they can control CCG budget spending, seeking continued support for health devolution, bringing forward Better Care Fund budget allocations for 2018/19 and investing in the financial sustainability of adult social care.

In London there is an adult social care funding gap of at least £600 million between now and 2020. Boroughs are spending up to 43 per cent of their budgets on adult social care. In July 2016 there were 564 delayed transfers of care in the capital. The total number of active Deprivation of Liberty Safeguards (DoLS) applications boroughs are processing is 25,430.

Cllr Ray Puddifoot MBE, London Councils Executive member for social care, said:

“The health and social care system in London is facing a range of challenges and boroughs are willing to deliver the service transformation and efficiency savings needed to overcome these. But without government involvement and support, our ambitions for greater integration could falter. 

“Financial data and performance statistics paint a picture of a health and care system under serious strain.

“Unless boroughs and the NHS transform services at a faster rate using the powers, relationships and budgets they can access through integration and devolution, vulnerable Londoners’ health and wellbeing could be affected. 

“Our list of government asks is broad in scope as we know that action on several fronts is urgently needed.”

London Councils is asking government to:

1.    Give boroughs the powers to increase investment in adult social care, which will help to tackle the £600 million adult social care funding gap in London between now and the end of this Parliament.
2.    Create a governance structure for a fully integrated health and care system that gives Health and Wellbeing Boards a stronger role – for example over local commissioning budgets.
3.    Set up a multi-agency working group to look at the future funding of social care beyond 2020 and the viability of implementing phase two of the Care Act 2014.
4.    Support London in transforming health and social care through devolution.
5.    Invest in public health and prevention and ensure it is firmly on the integration agenda.
6.    Update Section 75 legislation to allow for greater flexibility in use and transfer of budgets between health and social care systems.
7.    Protect funding for social care in any future allocations designed to drive integration.
8.    Support areas that have evidence of clear plans for how they will move towards full integration by speeding their graduation from the Better Care Fund programme.

London Councils is meeting Department for Health officials today (Monday 17 October) to make the case for taking practical steps to promote integration in London. 


Notes to editor:

  • Click here to download London Councils' integration asks document, entitled ‘Taking Integration of Health and Care Forward’.
  • A delayed transfer of care is defined as when an adult patient is ready to transfer to a less acute stage of care but is prevented from doing so.
  • Figures for DoLS assessments in London are taken from the latest NHS Digital statistical release.
  • Figures for delayed transfers of care are taken from the latest NHS England statistical release.