Intended for healthcare professionals


Without integrated care within five years we risk another Mid Staffs, warns government

BMJ 2013; 346 doi: (Published 14 May 2013) Cite this as: BMJ 2013;346:f3152
  1. Gareth Iacobucci
  1. 1BMJ

The UK government has set out ambitious plans to fully integrate health and social care in England within five years, in a new blueprint hailed by ministers as a landmark moment in the future of the NHS.

The coalition government has pledged to establish new integrated care arrangements in every area of the country by 2015, with a view to fully integrating healthcare and social care by 2018.

The plans will be kickstarted by 10 “pioneer” areas around the country, which will be chosen by September 2013 to take the lead in testing “innovative, practical approaches” to integration, with other areas then encouraged to follow.

The government said that the move to accelerate integrated care across England was essential to stop the NHS from “buckling under the pressure” of an ageing population with increasingly complex healthcare needs and ongoing financial pressures.

Launching the plans at the health policy think tank the King’s Fund on 14 May, the care and support minister, Norman Lamb, warned that a failure to deal with the lack of coordination in the current system led to poor care and to resources being wasted and risked a repeat of the Mid Staffordshire scandal.

To mark the launch, the government has published a set of commitments signed by 12 national organisations,1 which it hopes will ensure that its vision is delivered across the NHS and local authorities.

The commitments include outlining how national resources will support local work; promising to ensure that tools are available to help; detailing how data and information will be used to enable integration; and formulating plans to accelerate learning across the system.

Clinical commissioning groups are also being encouraged to use their annual 2% funding allocated for non-recurrent expenditure to pay for new integrated care projects.

The government’s vision will be supported by the first concrete definition of integrated care and support, developed by the charity National Voices, and the introduction of new ways to measure patients’ experience of integrated care by the end of 2013.

The announcement comes after the UK Labour Party proposed to merge the budgets for health and social care and mental health services in England, when it launched its own flagship integrated care policy in January.2

Lamb said that the fragmentation that characterised the current system “has to change.”

He said, “Seriously ill people fall between the gaps. Too often patients get poor treatment. Too often the system looks dysfunctional, and the pressure is rising inexorably.”

“Unless we get everyone working effectively together and stop duplicating effort and start keeping people out of hospital, then the NHS will eventually buckle under that pressure. The risk is the NHS will be branded with the perpetual risk, perpetual underachievement, and ultimately failure, and we will see another Mid Staffordshire,” he warned.

Lamb added, “This national commitment to working together is an important moment in ensuring we have a system which is fit for the future.

“Inside the treasure chest of integration lies the solution to the challenges that will define the future of the NHS.”

Responding to the announcement, Chris Ham, chief executive of the King’s Fund, described integrated care as “the central challenge that defines modern healthcare.”

He said, “To meet the needs of an ageing population and transform services for the growing number of people with long term conditions, it is essential that coordinating care and support becomes the core business of everyone working in the NHS and social care. So today’s announcement is an important statement of intent from the government and the organisations signed up to the shared commitment on integrated care and support.”

Johnny Marshall, director of policy at the NHS Confederation, the membership body for organisations that commission and provide NHS services, said, “It is now up to health and social care leaders to pick up the baton, challenge the barriers that currently prevent the best joined-up care, and look at radical ideas that will create improvements.”


Cite this as: BMJ 2013;346:f3152


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