Joining up health and social care?

There’s been lots of discussion of the Nuffield and King’s Fund report on integrating health and social care, which came out this week.

Two personal thoughts on integration of health and social care: one is the view of Richard Jones, one of the most effective social services directors (and our newest Trustee), who says something like, Don’t ask us to integrate our structures, because we will. But it will take up all our attention and on past experience it’s doubtful whether end users will notice the difference.

The other is, do we need integration at the level of structures, at the level of communities (perhaps through GP practices and their colleagues commissioning jointly on a small scale), or at the level of the individual. If individual payment by results support contracts were based on a unified outcomes framework (across health and wellbeing) and if people with long term support needs had the opportunity to pool personal budgets awarded by both social care and the NHS, how much would it matter whether the area’s head honchos were part of one organisation, or just good friends?