The former care and support minister has described the initiative he previously championed as “an example of where the NHS just gets it so wrong”.
Norman Lamb, the Liberal Democrat MP for North Norfolk, launched the integrated pioneer programme in 2013.
The five-year scheme chose 25 centres to become ‘integrated care pioneers’ to join up health and social care, with access to the £3.8 billion Integration Transformation Fund.
At the time, it was promoted as leading the charge for a ‘whole system’ way of delivering care that was hoped would generate significant efficiency savings. In June 2014, shortly after the first 14 pioneers were announced, Lamb described the programme as "really fascinating and excellent work”.
Earlier this month, Lamb told Digital Health News the pioneers were meant to turn “on its head the normal approach whereby the centre forces change”. This approach, popular during the National Programme for IT, “never works”, he said.
However, just two months after the last pioneer centres were announced in January 2015, NHS England revealed 29 vanguard sites, which would “trial new models of integrated care”.
Lamb said after getting reluctant NHS England support for the pioneers, the vanguards programme “crushed the emerging programme we tried to set in train”.
“Then along comes the sustainability and transformation plans, it’s just like an initiative-itis that just swamps people and drives people to despair.”
The NHS vanguard sites were announced in early 2015, with the STPs following in December 2015.
The STPs divides England into 44 “footprints”, which each must develop an integrated plan outlining how health and social care organisations in the area will transformation care delivery to help the NHS close the £30 billion national funding gap projected by 2020/21.
Not all the plans have been published yet, but the STP programme has already come under criticism for being secretive, unrealistic, and inadequately funded.
As for the pioneers, a paper published by the Policy Innovation Research Unit, at the London School of Hygiene and Tropical Medicine, in May, raised concerns about their progress.
The report found that the centres had made little progress and were struggling with IT and information governance issues.
“While technical problems, such as incompatible IT systems, were identified as making information sharing difficult, these were not seen as insurmountable,” the researchers added. “More problematic were issues of information governance, particularly in relation to accessing general practice data.”
The researchers concluded that despite the faith put in integrated working as a source of significant cost savings, the pioneers ran into growing difficult as the NHS’s financial situation deteriorated.
Lamb said his “great frustration” with the pioneers was that they were not given more power to push the programme.
“I think they had enormous potential, instead I think it’s rather faded from view because we’ve had two big initiatives since then which have crushed it”.
Lamb continues to call out the government on health. Last week he joined nine ex-health secretaries, signing a letter condemning the treatment of mental health patients, and urging the Government to act.
Published last week in The Times newspaper, the signatories wrote of the “enduring injustice” faced by those suffering from mental ill health.
Read more in our profile on Norman Lamb and his view on NHS digital transformation here.