Combining health and social care – the NHS future?


As the UK’s Health Bill is ‘paused’ for further and wider consultation, there appears to be a growing appetite for bringing health and social care together under the NHS.

Perhaps the most persuasive voice promoting the concept comes from Stephen Dorrell, the former Health Secretary, who stated in the Opinion column of last weeks’ The Times:

Stephen Dorrell

“The heart of the problem is that health and social care is riddled with separate bureaucracies. Acute hospitals, GP surgeries, community health services and social service departments – to name only the four principal categories – all run separate budgets, with separate management structures and, critically, separate information systems. Roughly 75% of NHS spending, and almost all social care spending, goes on patients with long-term, often multiple conditions. These people do not experience the classic cycle of diagnosis, treatment and recovery but need sustained help with multiple needs. This requires a much more integrated approach that traditional NHS structures are ill-suited to provide.”

Source: The Times – Monday May 16th, 2011


In addition to a better service, Dorrell also believes such an integration would be more cost-efficient, so helping the NHS to attain its 4% efficiency targets.

Dorrell’s voice carries further weight, as he currently chairs the Commons Health Select Committee, and it is expected that the Dilnot Commission will make similar recommendations when it completes its year-long study into affordable funding for care next month.

In addition, the Prime Minister himself said: “Change … must tackle the longstanding and damaging divide between health and social care, including the bed blocking that still afflicts so many of our hospitals. It must assist with the challenge to increase efficiency, raise productivity and keep costs down so we can go on meeting everyone’s needs.”

At Customer Faithful, we take care to avoid any political leanings, and try to focus exclusively on the persuasiveness of the argument, as well as evidence from our own healthcare research.

Our sense is that this integrated health and social care concept is in line with what the majority of patients and their loved ones want. Our current work in exploring patient experience of health conditions such as rheumatoid arthritis and dementia demonstrate a common frustration – that the imposed division between clinical care and social care funding frequently compromises the net delivery of care, and so impacts quality of life for patients and their loved ones.

Further reading:

Editor’s Note: Bed-blocking occurs where local councils seek to continue a patients’ stay in hospital (payable by NHS) to avoid footing the bill themselves for their care once they leave.