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A Partnership to make a difference: Integrated Care Systems and Adult Social Care Providers

Sir David Pearson Former Director of Adult Social Care and Chair of an Integrated Care System

As a former Director of Adult Social Care and Chair of an Integrated Care System, I have seen the benefits of joining up health, care and wider local government led services with local organisations. Adult social care providers in working with local communities make a real difference to people’s lives.

It’s not easy. There are long-standing cultural differences between health and care, dating back to 1948. Whereas the NHS is unified and publicly funded, adult social care is diverse, led by 152 local authorities with nearly 18,000 providers in 39,000 settings, largely independently run by private sector or charitable organisations.  

ICSs represent a real chance to do things differently and to overcome some of those historical challenges by pulling together key partners to develop and reshape services. Social care providers have a chance to share their considerable expertise in providing care and support and helping people to live the best lives they can.

As Don Berwick, an international expert on integrated care suggests, it will take robust and understanding relationships:

Integrated Care Systems are not based on structures but relationships – the life blood is affection, reflection, dialogue and problem solving.

Given the increasing need in our communities and the challenges resulting from the COVID-19 Pandemic, it has never been more important to develop innovative, collaborative approaches to improve how people are supported to live independently and to get timely care, when and where they need it. Adult social care providers deliver crucial services to millions of people and are a key touch point with local communities.

There is considerable diversity in how adult social care and support is provided, ranging from large providers that may operate nationally or across multiple ICSs to grassroots groups supporting people in their local community. The sector covers for-profit and not-for-profit organisations and provides many different types of support beyond assessed and council-funded care packages.

It’s important to note that care providers employ the majority of the overall social care workforce – currently 1.54m people.

Providers also work alongside an estimated 8.8 million unpaid carers, the army of family and friends who support so many people in this country.

It is clear the sector has an essential part to play in recruiting, developing and retaining staff in the health and care workforce. This has been illustrated in Better Lives Lincolnshire, where partnerships with adult social care providers have unlocked innovative approaches to creating a multidisciplinary workforce, such as introducing a care home trusted assessor role which not only supports safe and timely discharge by enabling assessments to be carried out more quickly, but also helps to develop trust and relationships across the system.

Addressing shared challenges takes commitment. This has been evidenced in West Yorkshire Health and Care Partnership where they have recognised the need to support workforce pressures through a long-term sustainable settlement for social care and invested £12m from individual NHS organisations into social care to enable providers to increase pay in the sector ahead of the April 2022 uplift in the National Living Wage.

Millions of people across the country draw on care and support from social care providers whether in a care home or in the community. It is essential that care and support providers are fully integrated into the development and implementation of plans for integrated care.  It’s a partnership that can make a real difference and for those who need health and social care services there is the real prospect of improved outcomes.

There are examples up and down the country where well established and trusted relationships with social care providers have led to ways of delivering care and support which ensure that those people who need help most receive the right care at the right time as well as seeking ways to improve population health and wellbeing. 

In Gloucestershire they have adopted an inclusive approach to leadership development by embedding Gloucestershire Care Providers Association as part of the clinical and care professional network. This partnership at system level has fostered an integrated neighbourhood approach, directly improving outcomes for individuals with complex needs.

The voice of social care is often heard in ICSs via local authority commissioners and, as important as this is, it is also crucial that care and support providers are directly involved in the development of future plans as well as current services, to help create those innovative and ground-breaking approaches that are needed.

Having chaired national discussions involving the NHS and the social care sector I have heard that many providers are enthusiastic about the significant contribution they can make in ICSs so that local people can live the best lives they can.

The national expectations have been set, with commitment from Department of Health and Social Care, Local Government Association, NHS England and the Care Provider Alliance, and it’s now time for ICSs to take this opportunity and make it a reality.

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