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Following the publication of the UK Government’s Health and Care Bill, which sets out proposals for building a modern health and care system that delivers better and more joined-up care in local communities, a number of leading health and care organisations have shared their responses.

The Health Foundation, Association of Directors of Adult Social Services (ADASS), The Chartered Society of Physiotherapy (CSP) and NHS Confederation have all agreed that collaborative working across health and social care is the way forward but have differing opinions as to how effective the bill will be.

Independent charity The Health Foundation says that while integrated care could help improve care for patients, the Health and Care Bill does little to address fundamental challenges like the major backlog of unmet health care needs due to pandemic.

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Responding to the publication of the Health and Care Bill, Dr Jennifer Dixon, Chief Executive of The Health Foundation, said: “This is a Bill of two parts. Provisions to boost integrated care have widespread support and could help improve care for patients, although the potential benefits of these changes should not be oversold. The part of the Bill giving the Secretary of State more power over the NHS is politically driven, has no clear rationale and risks taking health care backwards.

“To ease the Bill’s passing, the new Secretary of State for Health should now drop the contentious proposals to give his role more power over the day-to-day running of the NHS. He should add his own stamp to the Bill by adding simple but much needed provisions to improve workforce planning across the NHS and social care. This would help to ensure that staffing shortages in the NHS, which are slowing progress on the backlog, are addressed.

“In the aftermath of the pandemic, the country faces a major backlog of unmet health care needs, chronic shortfalls in the NHS and social care workforce, glaring health inequalities, and a social care system on its knees. The Bill published today will do little to address these fundamental challenges without wider policy action and investment from government.”

The Association of Directors of Adult Social Services agrees that integrating health and care will make a difference to people’s lives but says that the UK Government needs to urgently publish its promised plans for adult social care to complement the Health and Care Bill.

Responding to the Health and Care Bill, ADASS President Stephen Chandler said: “We share the ambition for care and support to be integrated in a way that makes a real difference to people’s lives and experiences. It will be vital that local government, adult social care and those who of us with care and support needs are represented in new and emerging local decision-making structures.

“We have also called on the Government to urgently publish its promised plans for Adult Social Care ahead of the parliamentary recess later this month, so that we can collectively ensure that they dovetail with and complement the provisions in the Health and Care Bill.”

The Chartered Society of Physiotherapy (CSP) adds that the bill’s shift away from competition and towards integration is a positive step and that person-centred care will help address people’s needs. However, it states that the bill fails to address the significant workforce issues that currently exist across the NHS and social care.

Brynnen Ririe, CSP’s public affairs lead for England, added: “This Bill outlines a welcome shift away from competition, towards a principle of integration, but as always the devil is in the detail. The planned changes will hopefully enable more integrated health and care in communities to deliver the needs-led and person-centred healthcare that the CSP continues to champion.

“But we are disappointed that it contains no reference to the provision of Integrated Care System (ICS) rehab leads at a senior level. We would also like to see stronger accountability – from the Secretary of State and Parliament, to ICSs – when it comes to workforce planning.

“It also fails to address the fact that there is an acute need to resolve the significant workforce issues that currently exist across the NHS and social care, as well as the ongoing and vital issue of recovery and rehabilitation from Covid-19.”

The NHS Confederation underlines that its members broadly welcome the bill and its push towards collaboration and partnership working at a local level. It says that, in many ways, the legislation is catching up with what is happening on the ground.

However, the confederation has voiced some concerns, as it states: “That said, there are some areas of the bill where we have concerns. As set out above, an issue we have been clear in opposing has been increased powers for the Secretary of State – notably in areas such as local service reconfigurations. Despite our opposition, the government is proceeding with introducing such powers and we are concerned about the implications this will have for ICS’ autonomy and the key role of local overview and scrutiny.

“We will continue to press for robust checks and balances to ensure that such powers are proportionate and limited.

“These reforms cannot be considered in isolation and their success will rely upon several factors not contained within the bill. The future of social care, for example, remains uncertain. We have been clear that ICSs must not be considered as NHS bodies, but as partnerships between the NHS, local government and the voluntary, social enterprise and independent sectors that bring together health and care.”

The NHS Confederation also highlights that it is concerned that local authorities will feel like junior partners in integrated care systems (ICSs) until they are given a sustainable, long-term financial settlement for social care. Echoing the CSP’s sentiments, the confederation further expresses disappointment that the Health and Care Bill is silent on addressing workforce shortages across health and social care.

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