NHS England and NHS Improvement have opened a consultation on building a strong, integrated care system across England. They are seeking views on their plans for increased integration and collaboration, which were originally set out in the government’s NHS Long Term Plan.
In this blog, Sue Ryder's Policy and Public Affairs Officer, Niamh Buckingham, welcomes the general direction of travel but argues that the overall lack of detail within the proposals mean many questions remain.
The right foundation for the NHS?
Ultimately, we believe that if a restructure is to take place, we should aim for fundamental reform rather than tinkering at the edges. We are not convinced that the current proposals go far enough and instead simply risk restructure fatigue amongst an already over-exhausted workforce. Not only that, we think the timescale for the reforms - complete by April 2022 - is totally unrealistic.
Of course, health and social care providers should collaborate - with people who use those services - to shape and deliver services. However, an enormous amount of preparatory work is needed to make this work effectively. This is even truer in light of the coronavirus pandemic, with huge backlogs in the health and social care system and massive strains across every element of the system.
The incentive mechanisms currently in place, coupled with political pressures prevent genuine long-term planning and collaboration and we do not think the proposed reforms address this in any way.
Partnership with the voluntary sector
It is vital that the voluntary sector becomes a true partner in the new structures that emerge from these reforms - this is not made clear enough in the proposals as they currently stand.
For instance, as specialist providers of palliative care and of neurological care, it is paramount we are involved in decisions on governance structures and decision-making processes that impact people who use these services, in order to influence and input to service redesigns.
Why we cannot wait
On top of this, we have the ongoing financial issues. Smaller providers such as ours cannot wait for reforms to take place before decisions on funding allocations are made: we need immediate clarity on our funding position or our services will be at risk, impacting on the wider health and care system and on people’s care and lives.
Policy and Public Affairs Officer