Source · Select Committees · Public Accounts Committee
Recommendation 7
7
Accepted in Part
Adult social care lacks sufficient weighting and understanding within health-led Integrated Care Systems.
Conclusion
When we pointed out that it was not always the case that social care got the right weighting in ICS structures because they are health-led, the Department acknowledged that the system was not working everywhere.10 The National Care Forum called for the appointment of adult social care leads on all Integrated Care Boards (statutory bodies that are responsible for planning and funding most NHS services in an area) to correct the tendency for everything to be viewed solely through a healthcare lens, noting that the voice of adult social care providers and people accessing care and support was often overlooked.11 Likewise, the County Councils Network (CCN) expressed its concerns that the structure of ICSs meant that key decision-making powers lay with the NHS, and that local government had limited representation on Integrated Care Boards. This, explained the CCN, meant that although joint decision-making can take place, it is not guaranteed that monies distributed by these means will always be allocated to social care. CCN also queried whether Integrated Care Board officials really understood how joint funding should be spent and the risk that it might be absorbed into spending on acute health pressures.12 6 Committee of Public Accounts, Introducing Integrated Care Systems, Thirty-Fifth Report of Session 2022– 23, HC 47, 23 January 2023 7 Committee of Public Accounts, Introducing Integrated Care Systems, Thirty-Fifth Report of Session 2022–23, HC 47, 23 January 2023 8 Department of Health and Social Care, Government response to the Committee of Public Accounts on the Thirty fifth report from Session 2022–23, 12 April 2023 9 Q 19 10 Q 20 11 RSE0004 12 RSE0031 Reforming adult social care in England 11
Government Response Summary
The government agrees with the committee's observation regarding social care weighting in ICSs and commits to new CQC assurance of ICSs and local authorities to assess how well partners meet population needs. It also plans to improve adult social care data quality and availability, though it does not commit to appointing social care leads on all Integrated Care Boards as suggested by external bodies.
Government Response
Accepted in Part
HM Government
Accepted in Part
1.1 The government agrees with the Committee’s recommendation. Target implementation date: Summer 2024 1.2 In Integrated Care Systems (ICSs), the National Health Service (NHS), local government, social care providers and other organisations work together to provide joined-up care and improved outcomes. 1.3 Through new Care Quality Commission (CQC) assurance of ICSs and local authorities (LAs), CQC will draw on data and evidence to independently assess how well ICS partners are meeting the health and adult social care needs of their populations, and how well LAs are delivering their duties under Part 1 of the Care Act 2014. These assessments will be published and will enable the public to better understand and compare people’s outcomes in different areas. 1.4 More broadly, the Department of Health and Social Care (the department) is improving the quality, timeliness and availability of adult social care data as outlined in its data strategy, Care Data Matters. Among other things, this includes the publication of better outcomes data, through a new social care person-level data collection, and a strengthened adult social care outcomes framework.