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Committee report on Social Care calls for joined up commissioning

8 February 2012

Older people are being let down by fragmented care services, says influential group of MPs.


The key to securing better outcomes for older people and other vulnerable groups, and to delivering the required efficiency savings for the NHS is joined up services, say MPs on the Health Select Committee.

Launching the report of a recent inquiry into Social Care (HC 1583, Fourteenth Report of Session 2010-12) Stephen Dorrell MP, Chair of the Health committee said,

"This report is latest in a long line of reports which have stressed the importance of joined up services. It is impossible to deliver either high quality or efficient services when the patient is passed like a parcel from one part of the system to another, without any serious attempt to look at their needs in the round.
This obvious truth has often been repeated, but seldom acted upon.
The funding for NHS care, social care and social housing comes from different sources. Apart from a few exceptions like Torbay Care Trust in Devon, attempts to join up these funds and to integrate services have been disappointing.
We welcome the government’s stated determination to tackle this long standing issue; the key is to move beyond restating the aspiration to addressing the question of 'how',"

adds Stephen Dorrell MP.

"Our central recommendation is that the key to joined up services is joined up commissioning.
We recommend that the Government should place a duty on the new clinical commissioning groups and local councils to create a single commissioning process, with a single accounting officer, and a single outcomes framework for older people’s health, care and housing services in their area.
This would improve outcomes by making it easier to move money around the local health, housing and social care system. It will also play a significant part in delivering the Nicholson Challenge for the NHS of 4% efficiency saving every year over the next four years.

This Government, like its predecessors going back to the 1960s, has stressed the importance it attaches to joined up services. Growing demand, coupled with an unprecedented efficiency challenge, makes it more urgent than ever before to convert these fine words into fine deeds. We look to the Government to set out in its Social Care White Paper how this vital objective will be met".

MPs also urge the Government to:

  • Co-ordinate policy more effectively across Whitehall and regularly rebalance national spending across health, housing and care services.
  • Replace the three overlapping but confusing frameworks that currently exist, with one outcomes framework for older people.
  • Recognize the widening "funding gap" in social care services - between the number of people who need care and the amount of money currently in the system to deal with their (rising) needs.
  • Accept the recommendations in the Dilnot report for a series of caps on care costs and identify the level at which it thinks these caps should be set.
  • Take steps to ensure that GPs identify much earlier and assess more clearly the needs of carers providing essential informal care to the old and the vulnerable.
  • Develop a new, integrated legal framework to support integration of health, social care and other services around the needs of the individual.

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