Is the Health and Social Care Act 2012 preventing the NHS integrating services?
MPs say integration of health services and the organisations attempting to plan and deliver it are often hampered by current legislation, in particular the Health and Social Care Act 2012.
A Health and Social Care Committee report is also critical of the government’s efforts to communicate the benefits of NHS reforms to the public and in health service bosses’ failure to ‘consistently engage with local leaders in the design of service change’.
The report says the debate surrounding integrated care, sustainability and transformation partnerships (STPs) and accountable care organisations (ACOs) is often muddied by the mistaken belief that these organisations will herald a US-style privatisation of the NHS*.
It states: ‘Rather than threatening the integrity of the NHS, reforms to better join up the organisation of services, including health and social care, present an opportunity to row back the NHS internal market.’
MPs on the committee recommend the government legislate to remove legal barriers to more integration, a move they say may necessitate changes in primary legislation.
The committee also call for a national transformation strategy backed by secure long-term funding and a commitment to a ring-fenced transformation fund.
NHS leaders are banking on integration as a way of boosting efficiency, help organise services better around patients in the face of an ageing population, increasing cost pressures, more people with long-term conditions and multi-morbidities and an ‘unprecedented’ and prolonged squeeze on resources.
*There have been changes to the way NHS chiefs refer to these organisations over the past few months. Instead of ‘accountable care systems’ and ‘accountable care organisations’, official documents now refer to ‘integrated care systems’ and ‘integrated care organisations’. This has been interpreted as an attempt to distance the English model from the US model.