The head of NHS England has unveiled a radical plan for the reorganisation of how care is delivered in the community by giving vulnerable patients control of their own combined health and social care budgets.
As part of a move to save money as well as keep the elderly, disabled children, the mentally ill and those with learning difficulties out of hospital, NHS England chief executive Simon Stevens wants to see vulnerable patients control their own budgets to spend on carers, physiotherapists and psychotherapy sessions.
The new scheme would be funded by “billions” of pounds of public money from the NHS and local government councils, with most patients getting more than £1,000 to spend on care, though people with complex needs could get far more.
Speaking yesterday at the Local Government Association Annual Conference in Bournemouth Mr Stevens said the move was “essential for the survival of the NHS” and that he hoped five million people who using the scheme by 2018.
Patients would not receive cash directly under the new plan, but would be able to control a nominal budget with their doctors. The plans are an extension of a policy Government of personal budgets that has already started to roll out.
Richard Hawkes, chair of the Care and Support Alliance, said: “Every day we hear from older and disabled people who are going without the support they need to get up, get dressed and get out of the house. This is also putting unbearable pressure on family carers. This news is welcome, and should increase moves towards personalised care.”
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Although the plan has been broadly welcomed by patients groups and charities, Katherine Murphy, the chief executive of the Patients Association said it should not be seen as a “substitute for proper funding of services”.
This is a call echoed by Sarah Clifford from the Disabilities Trust, who welcomed the announcement but said the “bigger issues facing health and social care is one of funding”. While Dan Scorer, head of policy at Mencap, said it was “alarming that there has been no consultation thus far on how they plan to support these individuals and their families to make decisions about the support and services that best meet their needs.”
The call from the head of NHS England came the same day that the influential Commons Public Select Committee said that the Government “does not fully understand” the scale of the problems faced by local councils and care providers in looking after increasing numbers of elderly and disabled people.
Reforms are “risky, are not supported by new money, and do not acknowledge the scale of the problem”, the Commons public accounts select committee said - calling for a more “realistic timetable” for implementation.
Commenting on Mr Stevens’ speech Tony Travers, an expert in local government at the London School of Economics, said “What’s interesting is that we’ve seen the head of the NHS effectively discussing combining NHS funding with the coffers of social care at the local level, which carries with it the implications of the NHS reaching into stretched local government budgets.”
He added: “It’s worth remembering that the NHS has been protected from the cuts while local government has already faced substantial cuts.”
Care and Support Minister Norman Lamb welcome new NHS England plan last night, which he said offered people “more choice and more control over their care”. He added that he was “encouraged” that it could be taken “further” through the Better Care Fund, the Government’s most recent attempt at encouraging local government and NHS co-operation.
However Mr Stevens said the Better Care Fund had been a “source of great tension and controversy” and that “combing two leaking buckets” won’t create a solution for health and social care.