Recommendation 4

These reforms do nothing to address the longstanding tension caused by differences in funding and accountability arrangements between the NHS and social care. The Department, which has policy responsibility for both health and social care, is showing a worrying lack of leadership, and it is not clear who will intervene if relationships between local partners break down. The interdependency between health and social care services is well established. However, we are concerned these reforms will be a missed opportunity to make meaningful progress on how the NHS and local government can work together. The NHS and social care continue to maintain separate budgets despite the ambition of integrating services through these new reforms. NHS oversight is focused on the NHS’s objectives and while the CQC can identify problems in joint working, it is not clear how the Department intends to resolve them when they do arise. It is Introducing Integrated Care Systems 7 essential that MPs can support their constituents when they encounter problems with health and social care services, but the arrangements for doing so within ICSs are very patchy. Recommendation: The Department should, within six months, publish guidance for ICSs setting out how it will support systems to resolve joint working issues when these are identified by the Care Quality Commission.