MPs: Unify health and social care to tackle funding shortfall

Adult care, housing and health should be brought under a single commissioner in each area to improve support for older people and help solve social care’s funding crisis, an influential group of MPs said today.

The health select committee said care services for older people in England were still highly fragmented, despite successive governments’ commitment to integration, and real progress could only be made by bringing the commissioning of health, housing and adult social care together.

“It is impossible to deliver either high quality or efficient services when the patient is passed like a parcel from one part of the system to another, without any serious attempt to look at their needs in the round,” said committee chair Stephen Dorrell.

The committee also said current levels of adult social care funding were inadequate, with a rising funding gap between need and resource, and that public spending on older people needed to be rebalanced away from acute hospital care towards preventive health and social care in the community.

This could only be achieved by full integration that would enable a single commissioner to shift resources around the system, also enabling the NHS to meet its steep target of delivering £20bn in savings from 2011-15.

The committee called on ministers to place a duty on councils and NHS clinical commissioning groups to create a single commissioning process for older people’s health, care and housing, pooling all public resources, with a single accountable officer.

This should be backed by an integrated legal framework for health and social care for older people, which should be implemented instead of the Law Commission’s proposals to create a single statute for adult social care.

The report was strongly backed by council, NHS and voluntary sector leaders, though disability charities stressed its findings were equally applicable to younger disabled adults as older people. However, the Local Government Association warned that integration alone would not be enough to solve social care’s funding problems.

“Structural reform will only take us so far and unless it is backed with the necessary funding the old, the frail and the infirm will not receive all the support they need and deserve,” said LGA community well-being board chair David Rogers.

The health select committee also called on the government to accept the principle of capping lifetime care costs faced for self-funders, as proposed by the Dilnot commission last year.

However, while Dilnot called for a national cap of £35,000, the committee warned that this did not take account of differences in the costs of care between areas, which would result in people in poorer areas taking longer to reach the cap than those with equivalent needs elsewhere.

It suggested that the government should look at instituting a cap based on time spent funding your own care.

More on the integration of health and social care

Guide to joint working between health and social care

Social workers must join renewed effort to integrate care

Enhance your practice

Attend Community Care’s forthcoming conference on supporting people with dementia.