Chapter 2

The government has set an impossible task

The government’s flagship proposals to integrate health and social care will be challenging to implement but will achieve little benefit for local residents, senior figures in local government believe.

These findings of an LGC survey follow February’s publication of the long awaited white paper, Health and Social Care Integration: Joining up care for people, places and populations.

Health and social care secretary Sajid Javid and levelling up secretary Michael Gove declared that it represented part of “a bold vision for the future of health and social care” – one which “sets out a new approach with citizens and outcomes at its heart instead of endless form filling, unnavigable processes and a bureaucracy which sees too many people get lost in the system, not receiving the care they need”.

Among the proposals were plans to introduce “a single person accountable for delivery of a shared plan at a local level” and a pledge that the reforms would give health and social care professionals “access to the right data and technology to make more informed decisions”.

"Overcontrol from an NHS which doesn’t understand social care or local councils/ democracy"

Survey Respondent

However, the ministers also acknowledged that the white paper represented “the start, not the end” of “a new wave of reform”.

Local government will be central to this process, so to help gauge how confident it is about integration and making it a reality, LGC conducted a survey of senior local government figures in association with Microsoft business solutions integrator HSO.

In total, 43 people responded, including nine council chief executives and officers from adult social services, finance and other areas. The results revealed concerns about funding and relationships between the different organisations that will need to work together and frustrations with the white paper itself, but also a belief that
existing work at a local level provides a good foundation to build upon.

Overall, 42% of respondents said the effect of integration would be neutral for their residents. 24% said it would be positive or very positive, while 14% thought it would be negative or very negative.

Of the chief executives who responded, two-thirds said the reform would have a neutral effect.

And while most respondents appeared to be unconvinced that integration would deliver positive changes for their residents, they also believe the integration process  would be far from easy.

Overall, almost three-quarters (74%) said it would be difficult or very difficult for their organisation and its local partners to successfully integrate health and social
care. This compared with 9% who thought it would be easy. No one said it would be
very easy.

Several survey respondents said the culture of the NHS was a barrier to health and social care integration.