News / Labour turns attention to year-of-care model

By Seamus Ward

A future Labour government could use the year-of-care payment model to facilitate the integration of health and social care, shadow health secretary Andy Burnham announced.

In a speech to the King’s Fund, in which he launched Labour’s health and care policy review, Mr Burnham said the services must shift to ‘whole-person care’. The profile of hospital inpatients had changed, he said. They were now looking after a greater number of frail, elderly people with complex needs. And patient expectation had changed, with more wishing to be cared for at home. Without change, there was a danger district general hospitals would be like ‘warehouses for older people’.

He said the proposals were based on the assumptions that the economic climate would remain tight and that there could be no more top-down reorganisation of the NHS – any changes would be delivered by the structures and organisations the party inherited when it returned to power.

He said more could be achieved with the £104bn spent on the NHS and £15bn on social care. He proposed merging the budgets to produce fully-integrated health and social care, with commissioning carried out by local authorities and clinical commissioning groups.

‘We need incentives in the right place – keeping people at home and out of hospitals. If the NHS was commissioned to provide whole-person care in all settings – physical, mental, social, from home to hospital – a decisive shift can be made towards prevention. A year-of-care approach to funding, for instance, would finally put the financial incentives where they need to be.’

NHS hospitals would be paid more for keeping people comfortable at home rather than admitting them, he added. And over time it could allow district general hospitals to evolve into providers of integrated care, from home to hospital.

King’s Fund chief executive Chris Ham welcomed the speech, saying the shadow health secretary’s diagnosis of why NHS and social care needed to change was correct. However, he added the vision was ambitious ‘It leaves a number of unanswered questions, not least how plans as radical as these could be implemented while keeping his promise not to embark on further structural change.’