New White Paper: Government proposals for health and care integration

Last week the Government published a new white paper, ‘Joining up care for people, places and populations’, originally announced July 2021 alongside the Health and Care Bill. Alongside the People at the Heart of Care White Paper, these three pieces of legislation have together outlined considerable changes to the structure and approach of the country’s health and social care system.

The foreword to this latest White Paper is co-authored by the Secretary of State for Health and Social Care, Sajid Javid, and the Secretary of State for Levelling Up, Housing and Communities, Michael Gove, driving home the focus on a place-based and population-level approach to care. The White Paper aims to bring together the NHS and local government to jointly deliver for local communities, cutting back on bureaucracy and introducing a single person accountable for delivery of a shared plan at a local level.

This White Paper is ambitious in its attempts to set out what an integrated approach to health, community, and social care could look like in the UK, taking into account the wider determinants of health, and moving towards a more preventative approach. With the NHS still largely focussed on reducing the backlog in elective care, and Integrated Care Systems yet to be enshrined in law, there is a considerable way to go before these changes are achieved. In particular, greater clarity is needed on how the various pieces of legislation outlined above, and the Data Saves Lives strategy, will be brought together.

At techUK we work collaboratively with our members to push forward the best use of knowledge and technologies to contribute to care at an individual, regional and national level. We are passionate about helping those that provide care, and as we move to use more technology and gather data that can help create a more preventative and predictive approach to health and care, we welcome this once in a generation opportunity to support these initiatives. The localisation and funding will make valuable and lasting steps forward in harnessing the power of the health tech Industry. We look forward to using our energies to support the swift implementation of the actions needed to support the strategy.

Shane Tickell, Vice-Chair of techUK's Health and Social Care Council

Key announcements of interest to the digital health and care industry have been highlighted below.

Unlocking the power of data

The White Paper sets out the central ambition that if several organisations are involved in meeting the needs of one person, then the data required to support them needs to be available in one place. This aim is closely aligned with the work of techUK’s Interoperability Working Group, as well as the recommendations in techUK’s Ten Point Plan for Healthtech that aim to facilitate the seamless flow of data across and between organisations.

The key aspects of the White Paper pertaining to unlocking the power of data include:

Each ICS will implement a population health platform with care coordination functionality that uses joined up data to support planning, proactive population health management and precision public health by 2025
The Government will put in place systems to link and combine data to enable improved direct care and better analytics for population health management. This includes connecting data from every health and adult social care provider to provide a near real-time picture of NHS care

techUK look forward to seeing the final version of the Data Saves Lives strategy – due to be published early 2022 – to examine how this aligns with the aims set out in this document.

Social care

In the first reading of the Health and Care Bill, Sajid Javid set out the aim to “help ensure that NHSE is working effectively with other parts of the system including social care and public health”. With the Health and Care Bill currently passing through Parliament and the adult social care reform white paper published last November, this White Paper on integration provides the piece that should link the two together.

Key announcements relating to digital social care and its integration into the NHS include:

The ambition that shared care records will be in place for all citizens by 2024
The goal to achieve 80% adoption of digital social care records among CQC-registered social care providers by March 2024
The creation of a suite of standards for adult social care, co-designed with the sector, to enable providers across the NHS and adult social care sector to share information
The development of a roadmap for standards development, published April 2022, which will be underpinned by a new end to end process for development

techUK’s Social Care Working Group will be looking to work with NHS England’s Transformation Directorate to help establish the role of digital care providers in achieving this integration.

Integrated Care Systems

While the Health and Care Bill announced that ICSs would be moved to statutory footing, outlining the creation of Integrated Care Boards alongside other new bodies, this White Paper sets out further detail relating to the structure of England’s 42 ICSs. The White Paper puts forward an ‘ICS first’ approach, encouraging organisations within an ICS to use the same digital systems.

Key announcements include:

The creation of a single role that is accountable for shared outcomes in each place or local area, e.g., an individual with a dual role across health and care or an individual who leads a place-based governance arrangement
ICSs will need to develop digital investment plans for brining all organisations to the same level of maturity, including ensuring data flows seamlessly across all care settings
The Government will look to introduce mandatory reporting of outcomes for local places
The addition of a third board, the Integrated Health and Social Care Board, which will focus on services at ‘place’ level

Funding and procurement

As decision-making powers are increasingly transferred to an ICS level, industry is keen to hear in more detail how arrangements for funding allocation will shift or procurement processes may vary.

Key announcements on this topic include:

NHS and local government organisations will be supported to do more to align and pool budgets e.g., simplifying of regulations for commissioners and providers across the NHS and local government to pool their budgets to achieve shared outcomes
Digital investment plans should be finalised by June 2022 which include the steps being taken locally to support digital inclusion
Where necessary, the Government will intervene with ICSs and vendors - including by setting conditions of funding, producing guidance, providing support, encouraging disruption and leveraging other allies
Where appropriate, digital investment should be purchased and deployed at ICS level