The majority of local authority chief executives and council leaders don’t believe integrating health and social care will generate cost savings for their local authorities, according to a report by consultancy firm PWC.
The report, based on a survey of 125 UK council leaders and chief executives, found that 85% of bosses agreed that integration would improve care outcomes but only a third (32%) felt it would generate savings for their local authority.
When asked about barriers to integrated care, respondents highlighted a conflict in culture between local authorities and NHS providers and commissioners, funding pressures and misaligned incentives.
“The main barrier to integrated care is that our neighbouring local authorities ‘do not get it’. Some organisations do not get the bigger picture in fear that they may not exist as a result,” said one chief executive.
Another said: “Many in the health service believe they will be bailed out financially and so don’t fully embrace the need for change.”
Respondents were split on their views of the Better Care Fund, the £3.8bn pooled budget between adult social care and NHS that is due to start in April 2015. Asked if the fund had positively impacted their ability to deliver better public services, 30% agreed, 30% disagreed and 40% were neutral. Respondents said the “short timescale” was the biggest challenge to making the fund work, the PwC report said.
The report, PWC’s fourth annual survey of local authorities, also found that eight out of 10 councils leaders believed some councils would fail to deliver essential services within the next five years. Nine out of 10 thought some local authorities would run into serious financial problems over the same period.
The research also surveyed 2,000 members of the public. Just 35% accepted the need to reduce or close services in their area, a drop of 10 percentage points from 2011.
Graeme McDonald, director of local authority chief executives group Solace, said: “Understandably the public are now very concerned about the impact of these cuts on their community and their own lives, as reflected by acceptance reducing for these changes.
“Integration is key for the future of local public services as budgets continue to be reduced. It drives efficiency, but more importantly enables early intervention and prevention.”