Can the new Care Quality Commission divert funds upstream, from acute hospital care to prevention and intervention?

In the last 5 years, funding for the NHS has risen by 7.2% compared to only 2.7% for social care. Over the next 3 years, the NHS will receive real year-on-year increases of 4% compared with only 1% for social care. While there is a great deal of rhetoric around joint working, individual assessments have naturally focused local authorities and PCTs to meeting separate internal targets. While prevention and intervention are high on the policy agenda, funds are directed primarily at acute care. Will a new joined-up regulator create truly joined-up working and provide authorities the backing they need to redirect funds from acute care to prevention and intervention?

 

From 01 April 2009, the Care Quality Commission (CQC) will be the new independent regulator of health, mental health and adult social care in England. The CQC aims to champion joined-up care across services, centred on the individual. The objective is to improve the experience for people who move between health and social care, and ensure that services are universally safe, high-quality and personal. They have explicitly elevated prevention and intervention as key objectives.

 

Under the new regime, local authorities and PCTs will be assessed in line with existing regulatory regimes, including Comprehensive Area Assessment (CAA) and World Class Commissioning (WCC). However, there will be an additional common assessment of commissioning, rating how closely the local authority and PCT work together.

 

The CQC should provide sufficient clarity of purpose and explicit direction to enable braver authorities to justify the ring-fencing of resources to support prevention and intervention, highlighted as an essential component in the personalisation and transformation agenda. Some authorities have embraced a holistic approach to health and care and have aligned their operations and objectives. Newly created Care Trusts such as North East Lincolnshire and Solihull have combined responsibilities and budgets into single teams.

 

As with most initiatives, prevention can provide cost effective benefits if delivered well and can waste significant funds if ill informed and poorly conceived. Effective joined-up approaches will, therefore, require shared intelligence and open communication about the real needs of local communities. The Joint Strategic Needs Assessment is a first step but is merely a starting point. Real intelligence conveys comparative needs, trends and social context for all sub-communities. Detailed intelligence lets you identify suitable target groups for intervention and gives insight into how to communicate with groups whose needs remain unmet. Shared knowledge lets you benchmark needs and provision between client groups and regions.

 

Dr Foster has developed a joined-up commissioning platform for social care and health, building on its success in developing information systems for the NHS. Dr Foster’s Population Care Manager provides the insight needed to build effective prevention and intervention strategies based on very local, very detailed intelligence about needs and inequalities. When used in conjunction with its sister product, Population Health Manager, it provides the shared information platform needed to facilitate truly joined-up working practices to improve both outcomes and efficiency across social care and health.