Social services directors reflect on the challenges of complete health and care integration

A wide range of challenges need to be overcome in order for NHS and social care services to successfully integrate, according to experts from both sides of the divide.

Joint sector research, carried out by the Association of Directors of Adult Social Services (ADASS) and the NHS Confederation between April and May, finds that social care directors and local health service commissioners are largely in favour of the full integration for which £3bn of funding was announced in the Chancellor’s Spending Review last week.

However, the chief concern among those professionals who responded was that any wide-scale changes demand ‘strong leadership and commitment from the top’, with more than 80 per cent believing this to be the most likely cause of failure. Other leading concerns included clashes in organisational culture, as well as technical issues concerning methods of payment, data and IT systems.

ADASS President Sandie Keene comments: “Early evidence of closer work with the health service is entirely welcome. As it develops it will have a growing positive impact in accelerating the changes we are making and acknowledging the role of social care in the delivery of effective health services, particularly for those people with long term conditions.

“We should be mindful of the need to overcome the obstacles in the way, such as the lack of IT coherence between different agencies. And also, be aware of the important role strong local leadership can play in overcoming the challenges that integration poses. Overall the survey contains encouraging and positive early signs that the move towards integration is gathering pace and support where it matters most – in localities and across all levels of care staff.”

NHS Confederation director of policy Dr Johnny Marshall adds: “With everything going on in health and social care services over the past few months, there was a risk local leaders could have adopted a ‘hunker down’ mentality. What snapshot surveys like this demonstrate is the resilience which clinicians, practitioners and managers possess to continue to focus on patients and service users.

“The drive to develop integrated services around users transcends organisational upheaval and day-to-day difficulties of mismatched inherited computer systems. The job now for health and care leaders is to make sure we address residual barriers so the passion of our staff to integrate care around individuals is allowed to flourish.”