Responding to the report from the National Audit Office on health and social care integration

Sally Gainsbury, Senior Policy Analyst, responds to the National Audit Office report on the Better Care Fund.

Press release

Published: 08/02/2017

Responding to the report from the National Audit Office on health and social care integration, Sally Gainsbury Senior Policy Analyst at Nuffield Trust health think tank said:

“This report should be taken as a stark warning that the government’s plans to squeeze billions from the NHS budget by shifting care into the community are built on sand.

Of the £22bn the NHS has been asked to save by 2020-21, the Department of Health earmarked up to £4bn to stem from reducing hospital activity by integrating hospital, community health and social care services, in one form or another. But as the NAO’s report shows, there is currently “no compelling evidence” to support this assumption. Indeed, the report finds that the £5.3bn spent on integrated health and social care services last year failed to meet its most significant targets and as a consequence saw increased costs and workload for hospitals.

As the NAO finds, the evidence to support the assumption that billions of pounds can be saved by moving patients into the community simply does not exist, because there is so little data available on how much it actually costs to look after a patient out of hospital, making robust evaluation difficult. What’s more, even if it did prove cheaper to treat patients out of hospital, those savings could only be realised if the freed up wards or units were closed.  With many hospitals currently running at over 95 percent capacity, the prospect of that happening looks remote.

The report should serve as a wake-up call for government to rethink the assumption that continued funding constraints can be weathered without affecting quality of care and jeopardising the long term sustainability of the health service.”

Notes to editors

  • The Nuffield Trust will shortly be publishing a review looking at the evidence on shifting hospital care into the community. 

  • The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  • For further information please contact Katherine Jarman 020 7462 0555 or Kirsty Ridyard 020 7467 0552.