News / Miliband puts faith in integration savings

By Seamus Ward

Labour’s independent commission on whole-person care will examine different ways of bringing health and social care budgets together, the party leader Ed Miliband said.

Launching the commission, Mr Miliband said urgent action was needed to ensure the NHS and social care were financially sustainable and provided better services. He highlighted figures from the Nuffield Trust that estimated that the gap between demand and other pressures and resources would be between £23.5bn and £29bn by 2020.

This was calculated assuming the NHS achieves its £20bn QIPP (quality, innovation, productivity and prevention) targets by 2014/15 and that funding is held constant in real terms for the next spending review period.

The commission will be led by former Department of Health clinical lead for quality and productivity Sir John Oldham and will produce recommendations for implementing whole-person care within existing resources.

Ideas to be considered include a year-of-care approach to commissioning services for those with long-term or complex needs, which would replace payment by results. Labour believes this would shift the incentive to prevention rather than treatment. It will also look at whether local authorities should work in partnership with clinical commissioning groups with a single budget.

Sir John said: ??’Seventy per cent of activity and cost in the care system is for people with multiple chronic diseases, which includes a rising number of older people. Their care crosses organisational boundaries, and is fragmented.

‘If we don’t change, the crisis of need approaching rapidly will make the NHS and care system unsustainable, and reduce the competitiveness of our economy driving a spiral of decline. It is that significant,’ added Sir John.

Mr Miliband said: ‘The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.’

He argued that whole-person care, which would bring together physical health, mental health and social care into a single service, would save billions of pounds to be reinvested elsewhere in the NHS. ‘The commission will look at different ways of bringing the health and social care budgets together so we can build consensus,’ he added.