LDC Confederation: taking an active role in combatting discrimination

By Martin Skipper

Martin Skipper, Head of Policy for the LDC Confederation, discusses how the organisation is taking an active approach to addressing racism, working as part of the London Workforce Race Equality Strategy (WRES), to ensure that the dental profession benefits from the programme of work.

The aim of the London Workforce Race Equality Strategy work is to address the inequality experienced by a large proportion of the NHS workforce. The experience of professionals from black and minority ethnic backgrounds continues to lag behind that of white colleagues.

To address this imbalance, the objective is for the NHS in London to be a more inclusive place to work. The workforce strategy aims to create a step change by increasing the diversity of the workforce and promoting equality, diversity and inclusion strategies. This includes improving the leadership culture and growing and training the workforce. In a recent survey undertaken by the London WRES for Equality and Discrimination in Primary Care, around half of respondents said they had faced some sort of discrimination or harrasment at work, with 39 per cent saying that they had received this from patients. The remaining 29 per cent had been on the receiving end of discrimination or harrasment from colleagues. Of these cases only one third were reported.

Colleagues from Asian or African backgrounds were most likely to be on the receiving end of discrimination, and also less likely to know where to turn for help. Additionally, while ethnicity was the main factor reported to underlie discrimination and harrasment by a considerable margin, gender was the second most common factor. Unfortunately, responses from dental practice were very low, so few conclusions about issues specific to dentistry can be drawn.

Registration data from the General Dental Council, however, shows that many of the issues reported above can be expected to be true in dental practice. Over 50 per cent of dentists on the register are women, leaping to almost 93 per cent of dental care professionals (DCPs). At least 31 per cent of the dental workforce identify as Asian, Black, Chinese, mixed or other non-white ethnicity, with a further 17 per cent unknown. Around nine per cent of DCPs by contrast, identify as non-white, with a further 14 per cent whose ethnicity is not known.

There will be sizeable groups within both parts of the dental profession with at least one characteristic strongly associated with discrimination and harrasment. With 60 per cent of DCPs and 52 per cent of dentists being aged under 40, expectations of professionals will vary considerably from this younger cohort of professionals to their more established colleagues.

The LDC Confederation is supporting dental teams in several ways to make sure that their workplace is inviting and supportive to everyone. One these is working with the National Guardian’s Office to ensure that all practices in member LDCs have access to a clear pathway to a dental guardian. This impartial champion provides support and guidance to those in the dental team who are unsure of where to turn when they have a concern.

As many dental practices continue to be independent providers with relatively small teams, the LDC Confederation act as an impartial body able to support practices and practitioners alike. By providing this opportunity for confidential and impartial support we hope that a more open and accepting culture will be developed in dental practice.

We will continue to work with the London WRES to embed their plans for increased awareness among teams of the issues and behaviours, as well as providing a trusted environment for all members of the dental team to seek support. We will also maintain a campaign of zero tolerance towards harrasment and discrimination from patients. Individual LDCs will be working with their local training hubs to embed training opportunities at the local level and with EDI leads in the Integrated Care Systems to align practice processes and outcomes with those of system wide strategic objectives. Through these combined efforts, the LDC Confederation will continue to take an active approach to promoting equality, diversity and inclusivity in the dentistry profession.

Social care crisis leaves 500,000 adults waiting for care

By Gabriel Blaazer

More than half a million adults in England are waiting for social care assistance, says the Association of Directors of Adult Social Services (Adass), as staff shortages continue to impact the provision of care.

According to Adass’ research, the number of people waiting for either social care assessments, direct payments or reviews of their care has risen sharply over the last year. The research marks a 72 per cent rise in the numbers waiting for support, as similar research last year put the figure at about 294,000.

Adass president Sarah McClinton said the figures represent “a devastating impact on people’s lives,” while the government has said that reforming social care is a priority.

Published in May 2022, the Adass report, Waiting for Care, found that during the first three months of 2022, an average of 170,000 hours a week of home care could not be delivered due to workforce shortages, and that 61 per cent of councils were having to prioritise care assessments.

“The situation is getting worse”

The report states the capacity of the care sector to deliver on people’s needs has been sharply reduced, at the same time as England’s ageing population develops ever more complex care requirements.

It says that “despite staff working relentlessly over the last two years, levels of unmet, under-met or wrongly-met needs are increasing, and the situation is getting worse. The growing numbers of people needing care and the increasing complexity of their needs are far outstripping the capacity to meet them.”

The report also says that the government’s focus “of resources on acute hospitals without addressing care and support at home, means people deteriorate and even more will need hospital care.”

Adass argue that not only are people waiting longer for care, “but family carers are having to shoulder greater responsibility and are being asked to take paid or unpaid leave from work when care and support are not available for their family members.”

This was echoed by Helen Walker, Chief Executive of Carers UK, who has said the current state of social care is putting “even more pressure on even more families who are propping up a chronic shortage of services.”

Changes welcome, but not enough

The government states publicly that fixing social care in England is a priority, and the Health and Social Care Levy passed last month will see £5.4 billion invested into social care over the next three years, including £3.6 billion to reform the charging system for social care and a further £1.7 billion to begin “major improvements” to the sector. The added funding is cautiously welcomed, but critics argue the government needs to go further.

However, ADASS president Sarah McClinton said: “We have not seen the bounceback in services after the pandemic in the way we had hoped. In fact, the situation is getting worse rather than better. Social care is far from fixed.

“The Health and Social Care reforms go some way to tackle the issue of how much people contribute to the cost of their care, but it falls short in addressing social care’s most pressing issues: how we respond to rapidly increasing unmet need for essential care and support and resolve the workforce crisis by properly valuing care professionals.”

Responding to the ADASS report, Miriam Deakin, Director of Policy and Strategy at NHS Providers said: “This valuable report paints a worrying picture of unmet care needs and lays bare the pressures on the social care system, which are having a serious knock-on effect on individuals’ quality of life and independence, as well as the timely discharge of patients from hospital.

“Although hospital patients who are medically fit for discharge are made a priority for assessment, any delay to those assessments means a delay to people receiving the care they need and makes it difficult to maintain the flow of patients through the NHS.

“Equally worrying is the obvious need for more support to help people stay well and live independent lives in the community which would in many cases prevent, or delay, any need for hospital care.

“We must recognise the efforts of social care staff delivering more care in people’s homes over the last year and ensure they are paid appropriately to acknowledge their valued contribution.

“The ADASS report highlights once again the urgent need to properly fund and reform the adult social care system.”

Mental Health Act reform to tackle detention disparities

By Niamh Macdonald

The Queen’s Speech yesterday outlined government plans to change the Mental Health Act 1983, empowering the individual to have more control over their care.

The announcement included plans to introduce a draft bill which will change the criteria for detaining so that it is only used when necessary: if the person is a genuine risk to their safety or others and there is therapeutic benefit.

The definition of a mental disorder will also be amended in the draft to ensure no one can be detained solely for having a learning disability or being autistic.

Plans to reform the Mental Health Act 1983 follow the government-commissioned Independent Review, published in December 2018 and the follow-up white paper produced in January 2021.

The government set out a goal to ‘deliver a modern mental health service that respects the patient’s voice and empowers individuals to shape their own care and treatment.’ It also made recommendations on how to address disparities in how the act affects people from black, Asian and people from ethnic minority backgrounds.

The next steps will likely be that the draft bill is considered by a parliamentary committee to inform full legislation to reform the act. It is not currently clear when the draft legislation will be published but the proposals will be considered over the next year.

Responding to the proposed new measures, director of policy and strategy at NHS Providers Miriam Deakin said: “A new Mental Health Act on its own won’t be enough to guarantee high-quality mental health services or transform the way we deliver them for years to come. Mental health services are under severe strain from huge demand and limited resources.

“Covid-19 has left a significant legacy on the nation’s mental health, particularly for children and young people, and the effects of poor mental health are expected to last longer than in some other areas of care.

“Coming hard on the heels of the biggest health service reforms for more than 10 years under the new Health and Care Act, we look forward to seeing detailed government proposals to reform the Mental Health Act as soon as possible.”

Vicki Nash, Head of Policy, Campaigns and Public Affairs for Mind, said: “Over 53,000 people were detained under the existing Mental Health Act in England in 2020/21 – an increase of four per cent on the year before. As these numbers continue to rise, we urgently need to see the UK government implement the long—overdue legislative changes needed to give people greater choice and control over their treatment

“In most cases, people are detained under the Mental Health Act against their will because they didn’t get the right help when they needed it. Black people are hardest hit, with higher rates of detention and practices that restrict their liberty, including face-down restraint, which can be fatal.

We need the new Mental Health Bill to change this and we must see more investment in early intervention to reduce the number of people becoming unwell in the first place. Mental health problems become more difficult to treat if left unchecked, as well as more costly to the NHS.”

One week to go until The Healthcare Show opens its doors

By Integrated Care Journal

CloserStill Media, organisers of The Healthcare Show, taking place at ExceL London on 18-19 May 2022, are delighted to announce that over 3,000 healthcare professionals are registered to attend the largest, senior gathering of UK healthcare leaders.

Don’t miss out on your chance to attend The Healthcare Show, two days full of opportunities to increase your industry knowledge through CPD accredited content and to network with both old and new peers and learn about the latest products and services. Bringing thousands of senior healthcare managers and clinicians together who are striving to transform care and improve quality against a backdrop of Covid-19, it’s an event not to be missed.

Healthcare professionals can secure their free tickets online here

The Healthcare Show are extremely excited to open their doors again this year with a variety of new theatres and a fully booked exhibition hall. You will have ample prospects to develop professionally and examine the effects of Covid-19 within the healthcare sector.

Show highlights:

Louise Minchin, broadcaster and journalist, to chair the Healthcare Keynote Theatre
Co-located with the Digital Healthcare Show and The Residential & Home Care Show
Incorporating The National Association of Link Workers Conference and Awards Ceremony
Brand new theatres for The Healthcare Show 2022 include the Transformation Theatre, Clinical Priorities Theatre and Care Quality and Efficiency Theatre
Incorporating The Patient Safety and Infection Prevention Show
Patient Safety Learning Partner Lounge will offer a platform to share a combination of tools, resources, case studies and best practice
Meet CQC inspectors across health and social care at their Meet the Inspectors Hub and put all your burning questions to them

The programme is available to view here (subject to change).

Sponsorship is also now also open for the event. Should you wish to sponsor, speak or exhibit at The Healthcare Show please contact Mike Corbett on: m.corbett@closerstillmedia.com

For delegate enquiries, please contact Imogen Scott on i.scott@closerstillmedia.com

New digital maternity pathway goes live in Devon

By TPP UK

TPP SystmOne Maternity technology goes live at Torbay and South Devon NHS Foundation, digitising the entire maternity pathway, from ante to postnatal care.

This week, Torbay and South Devon NHS Foundation Trust have gone live with TPP SystmOne Maternity. The system has enabled the Trust to digitise their entire maternity pathway, from antenatal through to postnatal care. It is being used by all midwives in the region, including those based at the hospital and those working in the community. More than 2,500 women will benefit from the new system every year, with their maternity care now centred on a complete, integrated digital care record.

Following the go-live, midwives now have instant access to all of the maternity data they need. For example, midwives working in postnatal care can easily view all antenatal care and delivery details. All medical and nursing notes are captured in a single record. This provides staff with the information required to make the best clinical decisions and improve safety for mothers and babies. Advanced functionality in the system is also supporting staff with the management of more complex pregnancies, through enhanced clinical decision support, alerts, and a complete maternity timeline.

TPP maternity — TPP SystmOne Maternity in use at Torbay Hospital

There has been strong clinical engagement throughout the project, from midwives, doctors and nurses. The teams have used TPP’s powerful Clinical Development Kit (CDK) functionality to develop exactly the data entry templates and visualisations they wanted. All staff members can quickly capture the information they need for a complete antenatal, labour, delivery and postnatal record. The Trust have also used CDK functionality to create customised safeguarding content, helping to support and protect the most vulnerable families. Staff are also benefiting from interactive inpatient screens in the system, allowing them to manage bed capacity and perform safe, efficient handovers.

The go-live has also included providing TPP’s smartphone application, Airmid, to all women under the maternity service. This is putting women at the very centre of their pregnancy journey. Airmid allows women to access their maternity records, manage their upcoming appointments, complete questionnaires at home, and receive personalised advice and education material. Airmid supports better engagement and seamless communication between women and their maternity care team.

SystmOne also provides significant improvements to integrated care across the region and to multidisciplinary working. For example, maternity staff can immediately access any important information entered by GPs. This is significantly improving patient experience. Women only have to tell their story once, without having to repeat themselves. GPs can directly refer into the maternity unit, improving efficiency across both services. Additionally, all new births are now automatically registered with regional Child Health services, with no extra burden placed on NHS staff.

Tracy Moss, Head of Strategic Systems’ Software Development at the Trust, said: “We are excited to be working with TPP to introduce a new maternity IT system here at Torbay and South Devon NHS Foundation Trust. The new system is expected to bring a wealth of clinical as well as efficiency benefits for our maternity teams and the wider organisation. The families we care for will also benefit from the system, as the new associated Airmid patient app will allow them to view their records, access information and be more involved in their care. Moving forward, we would like to continue to work with TPP to deploy other SystmOne products, both within our maternity unit and across our wider Torbay and South Devon organisation.”

Charlotte Knowles, Managing Director at TPP, said that “maternity services will always hold a particular place in my heart. Having had three babies, I know, from personal experience, what a superb job they do. We are delighted that the Trust are already seeing significant benefits for staff and patients from TPP Maternity. The dedication of the staff here has been truly inspiring. We are looking forward to working together to continue to make better use of technology to improve the experience and outcomes for pregnant women and their families.”

Government failing on social care and health inequalities

By Kari Gerstheimer

The government’s failure to reform social care funding in the Health and Care Act is compounding regional health inequalities, writes Kari Gerstheimer, CEO and Founder of Access Social Care.

Speaking before a Cabinet meeting last month Boris Johnson stated that: “With household bills and living costs rising in the face of global challenges, easing the burden on the British people and growing our economy must be a team effort across Cabinet.” He added that “we will continue to do all we can to support people without letting Government spending and debt spiral, whilst continuing to help Brits to find good jobs and earn more, no matter where they live.”

However, the Prime Minister’s own assurances on protecting the British public from rising costs were set against the Government’s actions regarding the Health and Care Act, which has just been enshrined in law.

The Prime Minister continues to make promises to help the British people with the growing cost burden, while the Health and Care Act leaves those on the lowest income exposed to spending a greater proportion of their assets on care costs, during the worst financial crisis we have seen in generations.

The Government’s own amendment to the Bill, which was subject to a fierce debate in both chambers of Parliament before ultimately being voted through, means that the local authority support people receive to help them meet their care costs, will no longer count towards the proposed £86,000 cap.

This is all the while that the PM has continued to make promises to address the decades-long social care funding crisis and widening health inequalities. The £5 billion in extra money announced for social care over the next 3 years, is of course welcome. But there is no mathematical link between the amount of money and the level of need. The Health Foundation calculates that at least £8 billion are needed per year, just to deliver what councils are legally obliged to.

Failure on “levelling-up”

Research commissioned by Access Social Care, which provides free legal advice for those with care needs, shows that poorer areas with lower council tax and business rate yields have been worse affected by the reduction in the central Government grant for social care.

This means that people living in poorer areas where social care need is often the greatest, are already getting a bad deal compared to other parts of the country, which flies in the face of the much-vaunted concept of “levelling-up.”

Rather than addressing this unfairness, the Government’s amendment is compounding it, by leaving people living in ‘red wall’ areas having to spend a greater percentage of their total assets on care.

The Health and Care Act is a clear contradiction in the PM’s assurance to focus efforts on easing the burden for British people and protecting the public from rising costs. It will instead deepen the cost of living to the poorest of our society and widen long-standing health inequalities.

Access Social Care are already seeing cases where the cost of living crisis means that people cannot afford the social care they so desperately need. The Government urgently needs to do more to ensure that everyone can get the social care they need, at a price they can afford.

Addressing the increased demand in healthcare

By Capita Healthcare Decisions

With the current increased demand within health and care, it is vitality important for providers to recover from the pandemic and address the challenges faced around growing elective care backlogs, staffing pressures and rising costs.

Addressing these challenges requires industry leaders to come together and adopt value-adding solutions and technology.

In November 2021, Capita Healthcare Decisions announced a partnership with Microsoft, integrating our clinical content into the Azure Health Bot, part of Microsoft’s Health Cloud platform. The key purpose around this has been to address the patient backlogs faced and improving the patient experience through the use of new technology.

How does it work?

Capita Healthcare Decisions’ content on Health Bot uses AI to pre-empt a wide variety of patient conditions and emergencies, with 164 symptom-based algorithms and over 40 scenarios ranging from ‘call an ambulance’ to ‘self-care’. The content is customisable and adaptable, with 500 sets of care instructions, including appropriate medical information and guidance on what to do if symptoms worsen.

Health Bot users can now gain access to Capita Healthcare Decisions’ content, meaning providers have access to the evidence-based healthcare content service. Saving the patient time is a goal of the collaboration and simple everyday language is used in the place of clinical and medical terminology – delivering a more user-centric approach and promoting ease of understanding.

The service aims to give users flexibility through access to information on different devices and channels, enabling a swift referral to appropriate care. Health Bot also aims to reduce the risk to patients of ‘self-triage’ – when a person evaluates their own health concerns to determine what they should do next.

What makes the clinical content unique?

Capita Healthcare Decisions produces content which is peer-reviewed and updated by an internal team of doctors and nurses to ensure robust clinical governance.

The Health Bot is available through Microsoft’s Cloud for Healthcare, a platform that provides the structure which supports health information and patient management across healthcare organisations and health providers, both public and private. The service provides AI-powered medical data which is used by some of the largest healthcare providers, pharmaceutical companies, and tele-medicine services in the world.

How will this help?

Steve Fearon, CEO of Capita Health Decisions, said: “We are proud and excited that our relationship with Microsoft continues to grow and strengthen. With this collaboration of our world-leading clinical content, available within the Microsoft health ecosystem, we have recognised the need to provide instant access to safe and accurate medical and peer reviewed content to support positive health outcomes. We are seeing just how vital the need for this offering has become, especially at a time of growing misinformation online.

“We see this collaboration as a great opportunity for organisations to completely transform and revolutionise access to healthcare, levelling the playing field in terms of equity in access to the most up to date health guidance, and ensuring that health resources are optimised to drive clinical and operational efficiency and effectiveness.”

Hadas Bitran, Partner Group Manager at Microsoft Health and Life Sciences, said: “Capita’s content is a valuable asset in the Health Bot service that empowers healthcare organisations to assist in triaging and directing patients to the appropriate level of care and to navigate the services available to them. Timely access to quality medical information saves lives; and deepening our relationship with Capita will further strengthen the patient-centric approach that is fundamental to our Health Bot service.”

Capita Healthcare Decisions have been at the forefront of tackling the challenges within healthcare systems for over 27 years. To find out more, visit: https://capitahealthcaredecisions.com/healthbot-cs/

Community Care, News, Population Health, Social Care, Thought Leadership May 9, 2022

The UK must harness data and digital to revamp stroke aftercare – Mike Farrar

By Mike Farrar

Stroke is the single largest cause of complex disability and long-term thinking around stroke aftercare is critical in easing pressure on health and social care.

The NHS Long Term Plan places stroke aftercare as a key priority area for improvement. However, ongoing data shows that the promises to ensure the best performance in Europe for delivering clot-busting thrombolysis by 2025 and increasing the number of patients receiving reviews of their recovery needs (from 29 per cent to 90 per cent), is unlikely to be met.

The stroke pathway has seen significant improvements over the last decade. These include the introduction of hyperacute stroke units, improved brain-imaging, rapid thrombolysis and game-changing thrombectomy. However, it is likely that these interventions will be undermined by the failure to recognise the opportunities to help people return to productive lives after a stroke.

Stroke care is an area that has seen substantial improvement in the UK; while mortality rates have halved over the last 20 years, stroke remains the single largest cause of complex disability. Further to this, recent research from the Stroke Association five-year survival rates remains low.

The Stroke Association estimates that 100,000 people have a stroke in the UK every year, with two thirds of survivors leaving hospital with a disability. There are currently 1.2 million stroke survivors living in the UK, at an estimated cost to the health and care sector of £26 billion a year. This cost is expected to triple by 2035.

Missing parts of the stroke pathway

The provision of rehabilitation and aftercare is an essential element of the care pathway yet is often the least well supported and resourced, a situation not solely limited to stroke care.

This is not unique to the UK and clinicians in the USA are experiencing similar issues. Once a patient has left an acute situation, where the latest interventions, medications and technological advancements have been provided, the same level of attention just isn’t there post-discharge. There is often a marked deterioration in wellbeing with an undetermined longer-term impact.

Stroke aftercare: a faulty mindset

There is an underlying mindset within the system that the priority lies with acute care management and what happens after is less important. As a system, crisis response is generally exceptional, and innovation and resources tend to be focused on this stage of patient’s journey. But there is very little strategy – and the funding treadmill is perpetuated by continually focusing investment on acute interventions. But it is clear that the cost benefit is poor if a more strategic view of the whole care pathway is not taken.

The failure to provide effective rehabilitation immediately after an acute episode can lead to reduced functioning mobility and normal life for the individual. The consequence of this failure is an added cost for the health and care system, reduced economic productivity and can increase social care costs if it leads to patients losing their ability to live independently.

Masking the real data

The data currently collected typically identifies re-admitted patient episodes as a new case rather than allowing the system to recognise and then count it as a re-admission. This often masks the failure of the rehabilitation and ongoing support offered, which could have prevented further problems.

The link to co-morbidities is also missing, with more people dying in the first six months after a stroke from cardiac events, rather than consequences of a stroke – which means we are overlooking opportunities to influence outcomes in other ways.

The cost of high-quality rehabilitation may pay itself back over time but immediate cost pressures in the system can often mean that rehabilitation is not funded as a priority, in turn reducing patient outcomes.

Balancing the funding model

So, what should the path forward be from here? The key to achieving the right balance is to argue the need for a greater use of data and to provide the evidence to build up the business case. There are some professionals and clinicians leading the charge and looking for that evidence to balance the funding model.

The Mount Sinai health system in the USA recruited a randomly selected sample of people who were enrolled in a remote monitoring programme. Of the sample, 90 per cent of the sample had a crisis that the health system could have intervened on. Without the follow-up, these crises would never have been caught.

In Cardiff and Vale in Wales, they’re currently trialling a system that joins up the data to the patient – rather than the episode – to track the re-admissions and the patient’s entire journey through the health system. The data outcomes are providing interesting insights into chronic conditions and helping to modify care providers’ understanding of where they put their money.

The role of data and digital in stroke aftercare

There is also seeing a role for digital platforms to be used for virtual rehabilitation. There are many ways to do this and the growth of digital care technology in local authorities should be used to support and endorse these changes across the whole health and care system. As an example, Visionable’s platform allows any deterioration in health to be identified early to prevent serious problems occurring, including readmissions. As people wait longer for care, this early warning is crucial to avoid patient harm.

There’s a real opportunity to shift the way rehabilitation pathways are approached, and how outcomes are tracked. This dialogue should really appeal to the new integrated care systems and their integrated care boards as the NHS embark upon seismic structural shifts in 2022.

Through system-wide commissioning, there is the opportunity to balance the investment and provide transformation – and to deliver a genuine whole pathway, including more robust rehabilitation services. Enhancing data capture in real-time and making sure the money follows the patient could produce marked differences – not only for the public purse, but in the quality of people’s lives.

All news

Royal College of Physicians issues stark warning over social care crisis

By Gabriel Blaazer

The Royal College of Physicians is warning that the combination of an ageing population and a lack of NHS workforce planning means the country is risking an unavoidable crisis in social care for older people.

The Royal College of Physicians (RCP) has issued a stark warning that NHS workforce shortages are driving the social care crisis in England and that the NHS is “woefully unprepared to cope with an ageing population.”

New analysis from the RCP shows that there is the equivalent of just one full time geriatrician per 8,031 people over the age of 65 in England. The findings use data from the RCP’s own census of physicians and the Office for National Statistics’ (ONS) population data and demonstrate the extent to which England’s care crisis is only set to grow.

The ONS estimates there will be more than 17 million people aged 65 and above in the UK by 2040, meaning 24 per cent of the population would require geriatric care. Additionally, many of the doctors currently providing geriatric care will, themselves, soon be requiring the same care, and 48 per cent of consultant geriatrics are set to retire within the next 10 years.

Considering these trends, the RCP, along with more than 100 medical organisations, is supporting an amendment to the Health and Social Care Bill requiring the government to publish “regular, independent assessments of the numbers of staff the NHS and social care system need now and in future.” No such data is currently publicly available. The amendment, currently being debated in the House of Lords, was tabled by Baroness Cumberlege and is supported by former NHS England Chief Executive Simon Stevens (now Lord Stevens of Birmingham), is set to be debated in the House of Lords

Responding to the RCP’s warning, Danny Mortimer, Chief Executive of NHS Employers and Deputy Chief Executive of the NHS Confederation, said: “As exhausted NHS staff strive to tackle the enormous treatment backlogs that have resulted from the pandemic, we must not forget about the pressures that our health and social care services face as they work to meet the growing needs of our ageing population.

“To be able to plan effectively for a future workforce, healthcare leaders need clarity in the shape of a clear long-term workforce plan. Sajid Javid’s recent commissioning of a workforce strategy is a very welcome step, but… we would urge the government to accept amendments requiring the health secretary to publish regular, independent assessments of the numbers of staff the NHS and social care system need now and in future.”

The President of the RCP, Andrew Goddard, said: ““I have dedicated my career to working in the NHS – a service that I am fiercely proud of – and yet it scares me to wonder what might happen should I need care as I get older. There simply aren’t enough doctors to go round, not least within geriatrics.

“The workforce crisis we’re facing is largely down to an astonishing lack of planning. All successful organisations rely on long-term workforce planning to meet demand and it’s absurd that we don’t do this for the NHS and social care system. The government needs to accept the amendment put forward by Baroness Cumberlege and make workforce planning a priority.”

Dr Jennifer Burns, President of the British Geriatrics Society, said: “These figures show very clearly the current nationwide shortage of geriatricians – a situation that will only get worse with the predictable rise in the numbers of older people across the UK needing healthcare.

“It is absolutely vital that these fundamental issues around the recruitment, retention, development and support of the workforce are addressed, and that there is a properly-resourced strategy for future needs. The British Geriatrics Society stands with the RCP in strongly supporting the amendment to the Health and Care Bill.”

New white paper seeks to clarify what integration means for patients

By David Duffy

The government has published its eagerly awaited Integration white paper, designed to clarify exactly how integrated services will improve care for patients and end users across England.

The paper outlines a series of priorities for integrated care systems to improve health and care delivery. These include enhancing transparency and choice of care increasing earlier intervention of care, as well as increasing flexibility and developing clearer communications between different service providers and enhancing overall value for the taxpayer.

Commenting on the paper, Prime Minister Boris Johnson said: “These plans will ensure no patient falls between the gap [between services], and that everyone receives the right care in the right place at the right time.”

This sentiment was echoed by Health and Care Secretary Sajid Javid, who said: “Our Integration white paper is part of our wider plans to reform and recover the health and social care system, ensuring everyone gets the treatment and care they need, when and where they need it.”

The Integration white paper follows a day after the NHS published its Elective Care Recovery Plan, outlining how the health service intends to bring down ominous backlog figures and repair waiting times following Covid-19 disruption to services.

Proposals outlined in the recovery plan include a focus on community diagnostics and new approaches to care that will only be possible to deliver through integrated care systems (ICSs). This new white paper seeks to outline how health and care systems will draw on the resources and skills from across NHS and local government to “better meet the needs of communities, reduce wating lists and help level up healthcare across the country”.

Also commenting on the Integration white paper, Mathew Taylor, Chief Executive of the NHS Confederation said: “As these proposals are developed further, it is important that we recognise the differences that exist in local areas including in local relationships. They will need to evolve in their own way if we are to crack this agenda.

“Finally, for integration to work there needs to be joined up thinking across government as well as at local level. Ensuring this will allow local leaders the freedom to work with their communities to identify what will provide the best outcomes for the public.”

Hugh Alderwick, Head of Policy at the Health Foundation, highlighted the importance for adequate funding if these system reforms are to be possible: “Better integration between services is no replacement for properly funding them. The social care system in England is on its knees and central government funding over the coming years is barely enough to meet growing demand for care – let alone expand and improve the system.

“More integration is also little good if there aren’t enough staff to deliver services. Staffing shortages in health and social care are chronic, yet government has no long-term plan to address them.”

Analysis

For those who have been close to the integrated care agenda in recent years, or indeed attended virtually any event around integration, there will be little new insight within this white paper – nor will there be much to disagree with. Health and care integration is not a new concept, and so the broad concepts within the government’s latest paper come with little in the way of new proposals. The paper is more of a clarification on what integrated care seeks to achieve rather than an explanation as to how it will be delivered (the absence of additional funding proposals and clear strategy to address workforce shortages is telling).

Not that the document isn’t useful, public perception and understanding of integrated care is still very poor. Delivering integrated care in practice will be difficult unless this understanding is improved and, to this end, the white paper provides some useful clarifications.

But the timing of the paper is as important as its contents. Building on the recent publication of the Levelling Up white paper and published a day after the NHS elective care recovery plan, the Integration white paper is an attempt to show that the government are looking beyond the acute sector and are serious about “Levelling Up”.

The white paper also comes as the Prime Minister is desperately trying to build some policy momentum and move away from what has been a disastrous period for his premiership. Time will tell whether this series of flagship policy proposals (which will precede a further paper outlining specific plans to address health disparity) will provide the antidote to the partygate scandal.

Key priorities of the white paper:

Better transparency
More personalised care
Earlier intervention
Clear communication
Improved access to social care services through NHS data sharing
Better treatment
Better NHS support to care homes
Coordinated services
More flexible services
Better value for money