Sector leaders have welcomed government plans to force the NHS and councils to co-operate on adult care but are doubtful over a target to release £4bn in savings from improved joint working.
Under proposals in the care White Paper, the government, if re-elected, would force the NHS and councils to improve the “patchy” state of joint working, to help release resources to pour into frontline services.
As part of the £4bn in extra resources the government wants to find from 2014 onwards, the NHS would be required to spend £1.8bn on delivering social care in people’s homes.
Richard Humphries, senior fellow at think-tank the King’s Fund, said the paper had taken a “helpful stance” by making it clear that “integrated outcomes” were a key objective, but said that it “stretched credulity” that £4bn was achievable.
Jenny Owen, president of the Association of Directors of Adult Social Services, said she was pleased that the government pledged not to mandate how integration would take place, but said councils would struggle to deliver the efficiencies required.
“Maybe £2bn will come from local authorities,” she said. “That’s a significant amount of money and already local authorities are making enormous efficiencies.”
The government said it would not impose “organisational restructuring”, but would be “firm about the requirement” for health and social care services to be aligned through legislation in the next parliament.
It would also introduce shared mandatory outcome indicators across health and social care, as well as requiring local authorities and primary care trusts to jointly commission services.
Despite councils and primary care trusts having had the power to integrate services, pool budgets and share staff since 1999, the White Paper states that too few areas had taken advantage of these provisions.
A report last year by the Audit Commission concluded that existing joint funding arrangements between councils and trusts had made little difference to outcomes.
Health secretary Andy Burnham said: “We now need to look at this as one system, health and social care operating together, working in much closer partnership and more integrated across the country.”
Local Government Association group lead for adult social care Andrew Cozens said he thought the statements on integration were “not that radical”, but they were helpful in developing existing good practice.
Jo Webber, deputy policy director at the NHS Confederation, said the duty would deliver little as PCTs were already used to working with partners.
She said improved integration required changes at central government and regulatory level.