ICSs need to work more effectively with adult social care to address the problems of increased demand and reduced funding
“Investing in multi-disciplinary support for people to maintain their health and well-being at home helps to enhance healthy life expectancy, which benefits individuals and their families, reduces pressure on the NHS and reduces costs in health and care systems.” Jane Townson, CEO, Homecare Association
Integrated care systems (ICSs) are not doing enough to engage with the adult social care (ASC) sector, according to a new report from Care England, the Homecare Association and the Good Governance Institute.
The report, ICS Engagement with the Adult Social Care Sector in Decision-Making, says that little has changed in terms of engagement since its last review of the sector in May 2021. It makes a series of recommendations about what ICSs can do to address this. ICSs should note, for example, that the social care partner member on the Integrated Care Board (ICB) will not necessarily be able to effectively represent providers, and should work with providers to develop more effective engagement mechanisms.
The report, which is based on interviews with ICS representatives and ACS providers, also recommends that ICSs should develop a plan about how to engage with ASC providers and involve them in the process; have a provider forum or liaise with local care associations which nominate a representative to the ICS Partnership Board; and ensure that ASC providers have a role in the new local place arrangements, the Integrated Care Partnership (ICP) and/or the ICB. The report suggests that ICSs could do this by creating a paid position tasked with furthering the ASC agenda and “educating others around them on the issues facing the sector.”
Finally, the report recommends that the Department of Health and Social Care publish a specific framework for ICS engagement with the ASC sector.
The four themes mentioned consistently in interviews, the authors say, were:
ASC providers expressed concern that they were being represented by local authorities on ISCs, believing that each care provider group “has a distinct voice that needs to be heard.”
Workforce issues facing the ASC sector, the report says, include “employee retention, career progression, staff skills and the quality of training provided to them.” It says that these issues “have had a grave impact on the sustainability and the quality of service provided in the ASC sector.” It warns: “If this is not dealt with by ICSs as a priority, tens of thousands of vulnerable people could be left without access to the care they need.”
On the question of care service recipients, the report expresses concern that the combination of increased demand and lack of capacity has meant that the ASC sector is failing to deliver adequate care. Interviewees told the report’s authors that ICSs “need to…ensure service users are heard in their commissioning plans” and that “more work needs to be done with ASC providers on alternatives for when the quality of care falls short for service users.”
Funding for digital innovation in recent years has provided an opportunity for collaboration between ICSs and the ASC sector, the report says. However it notes that examples of this happening are “few and far between”, adding that “ICSs should constantly be looking at ways to innovate and collaborate with the ASC sector to provide digital solutions to help those being supported by services and staff.”
Commenting on the report, Jane Townson, CEO of the Homecare Association, said that homecare services “play a vital role, alongside housing, health and other community-based services, in enabling us all to live well at home and flourish in our communities.” She added: “Investing in multi-disciplinary support for people to maintain their health and well-being at home helps to enhance healthy life expectancy, which benefits individuals and their families, reduces pressure on the NHS and reduces costs in health and care systems.”
“The report correctly identifies the serious problems facing the adult social care sector, caused by a combination of rapidly growing demand and a reduction in funding. Some of these problems, in particular the shortage of staff in the sector, are so severe that they need strong and immediate action. Although we agree with the report’s authors that it is hugely important for ICSs to engage more effectively with adult social care, we feel that the report pulls its punches and much more needs to be done to address these problems as a matter of urgency. This could include collaborative working to improve interaction between providers to yield greater efficiencies, better user experience and outcomes, and greater adoption of evidenced-based technology to improve access and generate efficiencies.”
We invited Professor Martin Green, chief executive of Care England, to reply, and he said:
“The points made by FCC are very fair challenges, and there is an urgent need for action on all the issues they identified. However, the priorities and challenges differ across the country, and what we hoped to do in this report was give care providers an opportunity to think about how they engage strategically with the ICS in their locality, and how they can identify the local priorities and work in a collaborative way to improves services to local citizens”