Views & Reviews

Integration of health and social care would better safeguard adults from harm

BMJ 2013; 346 doi: (Published 21 May 2013) Cite this as: BMJ 2013;346:f3266
  1. Billy Boland, consultant psychiatrist and lead doctor in safeguarding adults at Hertfordshire Partnership NHS Foundation Trust, St Albans AL3 5TL
  1. billyboland{at}

On 14 May 2013 Norman Lamb MP announced the UK government’s intention for health and social care to be fully integrated by 2018.1 A cohort of experimental sites will be unveiled in September to trial new ways of delivering care, he announced. Healthcare providers and local authorities will forge new partnerships to tackle unmet need with the aim of avoiding patients falling between two stools.

Support for integration from patients and their carers is strong. National Voices, the “national coalition of health and social care charities in England” champions this cause, calling for integrated care to develop “quickly and at scale.”2 Its influence is considerable and growing—for example, it has worked closely with the NHS Leadership Academy in developing its new programmes to make sure the “patient experience is central to the programme.”3

From the perspective of patients, integrated care makes complete sense. In 2010-11, 95 000 adults were referred for safeguarding because of suspected abuse in England and Wales, with 44% referred by social care staff and only 22% by healthcare staff. Referrals from primary and community care made …

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