NHS, Integration and Innovation: working together to improve health and social care for all

The Department of Health and Social Care published a White Paper on NHS Reform on 11th February 2021 aimed at improving the integration of services and cutting back bureaucracy which causes delays. The proposals will put integrated care on a legal footing and will allow NHSE to delegate or transfer the commissioning of certain specialised services to ICSs singly or jointly, or for NHS England to jointly commission these services with ICSs.

The white paper follows an NHS consultation to which UKABIF responded. A Bill is expected to be laid before parliament when parliamentary time allows.

In proposing the White Paper, Matt Hancock stated that the plans would remove barriers to a truly integrated system seeing different parts of the NHS joining up more seamlessly, and the NHS and local government working side by side to address long-term challenges, and deliver our manifesto commitments, including 50,000 more nurses and 40 new hospitals.

The paper sets out the removal of competitive tendering - the aim being to leave clinicians with more time to focus on frontline care, and for leaders to keep driving innovation.

There may be some positive aspects to the paper for people with rehabilitation needs, in that Collaborative Commissioning is stated as a desired practice [ref:5.27] with commissioning following a patient through the pathway of their care by relaxing existing legislation where budgets currently cannot be used freely.

Amanda Swain, UKABIF Trustee and Policy Lead stated. ‘This may help commissioning of specialist services to meet regional population needs for Acquired Brain Injury (ABI) including stroke and other neurological conditions where people need rehabilitation that can address their complex needs (neurorehabilitation both residential and community). Previously a CCG may have commissioned level 2b and 3 rehabilitation for people on the Stroke pathway but the variation in services and quality of services for people with complex neurological rehabilitation needs other than stroke, still remained an area of confusion as to which commissioning body and which budget was responsible and to be commissioned from.’

UKABIF is working with other voluntary sector organisations and professional groups to respond to the paper. Initial concerns include the lack of AHPs in the Stakeholder list and the focus on data driven services without mandated stipulations for which data is collected and how - an area of huge concern for people with acquired brain injury which has a lack of consistent data.

A full copy of the White Paper is available here

https://www.gov.uk/government/publications/working-together-to-improve-health-and-social-care-for-all

• This briefing on the White Paper by the Whitehouse Consultancy provides additional summary of contents and context.