Admirable aspirations for integration but the lessons from earlier initiatives have not been fully learnt

Responding to the government’s Integration White Paper ‘Joining up care for people, places and populations’, Nuffield Trust Chief Executive Nigel Edwards said:

"This White Paper has admirable aspirations, and rightly recognises the scale of the challenge to integrate services but much of it covers well-trodden ground. While good work is already underway at a local level, it is not clear that lessons from earlier initiatives to bring together health and social care across the UK have been fully learnt [1].

“We are pleased to see that the rigid insistence on immediately merging NHS and council budgets which had been anticipated has been dropped for a more flexible approach. Cooperation between services and reduced fragmentation is good for patients and could reduce frustrating delays and repetitive processes. But previous attempts at integration show that it alone does not deliver financial savings, bolster social care or reduce hospitalisations as much as the government would hope.

"There is a risk that the White Paper overestimates the extent to which structural changes will produce the results expected. We also need to see workforce and funding issues addressed and allow the time and space to build the strong partnerships and cohesive culture where better results for patients can be delivered. The need for investing in better relationships with councils comes alongside the huge pressure NHS leaders remain under to cut waiting times and provide more care.”