William Eichler 21 February 2017

Health service reforms ‘not credible’ without social care investment

Local plans to reform health services to secure the future of the NHS are ‘not credible’ unless cuts in social care and public health budgets are reversed, think tank says.

A new analysis of sustainability and transformation plans (STPs) published by The King’s Fund has argued STPs offer the best hope of delivering reforms to NHS services.

However, it said the Government must back the reforms with the necessary funds and help to develop them into ‘credible plans’ focused on the most important priorities in each area.

STPs are proposals on how to improve health and care systems at the local level, developed jointly in 44 areas by the NHS and local councils.

The report, entitled Delivering sustainability and transformation plans, found all plans aimed to deliver more services in the community, including by putting GPs at the heart of networks bringing together primary care, community services and social care.

It also discovered some plans included proposals to reduce the number of hospitals, cut hospital beds and centralise some services on fewer sites. Greater emphasis was also placed on prevention and efficiency.

The King’s Fund said that while these proposals present an opportunity to ‘move care closer to home’ and moderate demand for hospital services, they are ‘not credible’ without more investment in local services and greater integration of out-of-hospital care.

'It is not credible for the Government to argue that it has backed the NHS’s own plan unless it is prepared to support changes to services outlined in STPs,’ said the think tank’s chief executive Chris Ham.

‘Local plans must be considered on their merits, but where a convincing case for change has been made, ministers and local politicians should back NHS leaders in implementing essential and often long-overdue changes to services.

‘A huge effort is needed to make up lost ground by engaging with staff, patients and the public to explain the case for change and the benefits that will be delivered.'

The Local Government Association (LGA) welcomed the think tank’s calls for better funding for social care and health budgets.

Responding to Delivering sustainability and transformation plans, chairman of the LGA's community wellbeing board, Cllr Izzi Seccombe, said: ‘We back the King's Fund in warning over the cuts to councils' social care and public health budgets, and share the concerns over how we can provide care in the community, improve prevention services, and keep people out of hospital.

‘Councils see STPs as an important vehicle in redesigning local care and health services to improve health and wellbeing, and the quality of care.

‘But we will be unable to achieve this without genuinely new money for social care. It is only by properly investing in social care that we can alleviate the pressures on the NHS.’

Cllr Seccombe also welcomed a call in the report for more effort to be put into engaging NHS staff, patients, the public, local authorities and others when developing STPs.

‘We have long warned that STPs can only be effective if councillors and communities are at the heart of the planning process,’ she said.

‘It is vital they are involved and not just consulted afterwards on pre-determined solutions. Any failure to engage councillors could lead to vociferous opposition.’

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