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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views

Question 39: Does the guidance on personalisation support integration of health and care (and any other state support)?


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  1. Anonymous says:

    The integration of care should include the main relative carer, and main care assistant as well as all other care professionals, to have input about the ability of the plan to meet the needs of the individual.

  2. Anonymous says:

    The guidance is supportive of integration of health and care, but has less to say about the integration with other forms of state support such as housing (recognising that housing is not exclusively state funded or provided). More examples of how services and resources from housing, health and adult social care can be integrated around individuals would be welcome. Sitra, on behalf of TLAP, is producing a version of Making it Real aimed at a housing audience and we would recommend that this is mentioned as a forthcoming resource.

    The guidance should also reference the audience towards Better Care Fund pioneers, with an understanding of the integration of housing, health and social care.

  3. Anonymous says:

    More direction should be given in the guidance to align the planning systems health, care, housing support.

  4. Anonymous says:

    We believe that the draft guidance goes some way to supporting the integration of heath and care, but that the combining of plans should be encouraged more strongly than the guidance currently suggests. Aligning the planning systems will require much greater direction and will also need to be reflected in other initiatives such as the Better Care Fund

  5. Anonymous says:

    No, because it will take more than guidance to make this happen particularly in relation to funding.

  6. Anonymous says:

    I believe the integration of health and care as it is currently being enacted is simply a way of easing more private providers into the NHS. This massive reorganisation, which has not been supported by any pilot schemes to test its efficacy, will effectively blur the boundaries between health and social care to normalise paying for health services. The huge administration costs of the Health and Social Care Act could be put to much better use to provide frontline services.

  7. Anonymous says:

    Erosh believes that the guidance needs to include housing as a fully integrated partner with welcomes the inclusion of housing with health and care and not just come under ‘any other state support’. In places also In places in the Act, housing is also referred to as a ‘health related service’ which undervalues the significance of housing as an equal partner with health and social care. ‘Registered providers of social housing are mentioned in the Act (6(3)(d))as as one of the appropriate ‘persons’ with whom a local authority would co-operate with but there is very little mention of housing other than this and insufficient recognition of the complex and interrelated range of services and accommodation which make up much supported and sheltered housing. The integration of housing with health and social care is what we have been arguing for not least because it provides better outcomes for older people.

  8. Anonymous says:

    The guidance could be made clearer to ensure health and other sectors are aware of their roles in the integration agenda. Change to culture and methodology will be needed rather than just a shared care record and guidance to achieve true integration.

  9. Anonymous says:

    The Housing LIN notes in paragraph 10.60 that the guidance seeks to align health and social care so that they there is a more coherent and streamlined system to avoid any confusion across to the two different systems. However, integration is so much more than with health and social care economies and decisions made within acute, community or social care can also have a significant impact on the way housing services are commissioned, funded and managed. Indeed, evidence from the Netherlands (below) suggests that if personalisation is merely seen as a means for rationing services and/or cutting budgets, this can both restrict individual choice and/or create uncertainly in the market. For example, exposing providers to financial (capital and revenue) risk.

    The Long Term Care Revolution: A study of innovatory models to support older people with disabilities in the Netherlands

    This study was undertaken to see what can be learned from the experience of the Netherlands about long term care in order to inform policy, research and practice in the UK.
    It found that while the two countries are very similar in demographic profile and the experiences of the older generation, it is notable that according to official statistics older individuals remain disability-free for nearly half a decade longer in the Netherlands than in the UK. However, with a rapidly ageing population, there is mixed evidence on the cost effectiveness of Personal Budgets for older people and they have been ended for new users since 2010. These changes have been implemented mainly to save costs to the state-sponsored social insurance fund; but they might put more pressure on informal carers.