21st Century NHS and Social Care : Delivering Integration

You can see the full challenge paper here – NHS, and the summary of the NPF discussions at Aston is here – Discussion_summary_-_Health.

Conference in September will debate the issue and confirm final policy.


Prior to the Aston meeting of the NPF, the Health and Care Commission had put out a first draft and then a revised “challenge document” – a short document outlining the main issues for this priority issue set by Annual Conference.

The main challenges Labour has to deal with were identified as:

  • the Coalition are cutting funding massively and fragmenting and/or privatising services
  • there is a contradiction in submissions: service users and professionals say that we should avoid another major reorganisation, but welcome our pledge to repeal the Health and Social Care bill and think integration would be a good thing, when both of these would necessitate major reorganisation
  • the division between health and social care services creates huge problems in a population where the number of very elderly people with complex needs is increasing
  • should we immediately and fully integrate health and social care into “whole person care”, or move towards this more slowly by create greater integration over time by moving to social care commissioning happening alongside health care commissioning?
  • how do we fund the increasing social care bill?

After the final NPF meeting at Aston in June 2013, the conclusions agreed were:

  • recent events have shown effective regulation is vital
  • we should move immediately towards full integration with whole person care, including physical health, mental health and social care together in a single service – but this will take time so we would need to move in evolutionary steps


  • Roger Steer  On August 16, 2013 at 8:51 am

    I would argue as follows:
    1. The Coalition are not cutting massively but they are destabilising and creating uncertainty and unnecessary upheaval. Just moving the deckchairs around causes massive reallocation of resources. Reconfigurations will damage local services forever.
    2.The Labour Party created opportunities for the private sector and voluntary sector to bid for contracts and for the hiving off of hospitals to FT’s and community services to non-nhs providers.
    3. It is not clear which aspects of the Health and social care act will be changed??
    4. There is a lack of clarity in the meaning of integration.
    Putting local govt of NHS services will not be acceptable to GP’s and doctors who fear political interference.
    5.Division of responsibility doesn’t cause problems- it’s the avoidance of responsibility that causes problems. Integration will not necessarily overcome lack of resources and the need to ration and deny care.
    6.Speed of integration isn’t the issue it is whether it will make any difference. It looks like a sop to local government.
    7.The important thing is to free up the supply of resources to the sector. Co-payments , liens on estates; obligations on relatives should all be examined. My French relatives have been confronted with bills when long lost fathers turn up in old peoples homes. If the Labour Party becomes the party of cash limits it is doomed.
    8. Effective regulation is vital and providers need to pay for it .
    9. Moving toward integration is meaningless and weasel words. What does it mean? Will it be supported and supportable? Saying it will happen and then not doing it is a recipe for disillusion. Is the objective to hive off and to subcontract disease management packages of care ? If so the Labour party needs to say so.

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