Integrated care “from home to hospital” is vital if the NHS is to reduce costs and address a sharp rise in long-term conditions, according to Labour’s new health and social care policy.
The party’s 10-year plan for health and care, released yesterday, also proposes integrating NHS 111 services with ambulance and out-of-hours services.
Labour’s plan states that the NHS “requires reshaping and improving services to meet evolving health needs like ageing, multi-morbidity, and mental health”, while also prioritising prevention to reduce demand.
“Our plan will help people get the right care, at the right time, in the right place. It is based on the simple notion that if you empower people, and make care personal to each family, it is more likely to work for them and cost less for everyone.”
It proposes replacing the national activity tariff with a “Year of Care” payment system for people at the greatest risk of hospitalisation, forcing accountable providers to bear all health and social care costs if a patient’s condition deteriorates and they need expensive hospital care.
“NHS organisations will have an incentive to start in the home and evolve into integrated care organisations, moving on from the 20th [century] hospital-dominated treatment model.”
However, the plan says a move towards integrated care “cannot be imposed by top-down edict and timetables”, and Labour would instead allow local organisations to design their own integration plans.
To support a move towards integration, Labour would change Monitor’s regulatory role to allow it to assess the financial viability of entire local health systems, rather than individual providers.
Labour says it will consult on how the ambulance service can be better integrated with NHS 111 and out-of-hours GP services.
The plan says patients should be given control of and access to their own health and care information, providing their details only once when in contact with services.
In a speech for the King’s Fund about the plan, shadow health secretary Andy Burnham said the challenges facing the NHS “can’t be achieved with…another imposed re-organisation without consent”.
“Instead, the journey to a national health and care service must be one that everyone is invited to join and everyone has a part to play; where change is not dropped on people from a great height but worked at and built by people in every community.”
Burnham said integrated care is vital to ease pressures on public spending, address the complexity of long-term conditions and encourage prevention of diseases rather than treatment after the fact.
However, he said a Labour government would not “mandate from on high” but encourage local decision-making.
“We won’t impose one way of doing things – one model of care – but let different places find their own way to solutions that are right for their area.”