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UK government publishes plans to improve health and social care integration

A white paper outlines measures including digital care records under move to help individuals receive “better, more joined-up care”

The Department of Health and Social Care (DHSC) has published a new white paper outlining measures to improve the link between the NHS and social care, including technology-led initiatives such as digital care records.

Delivering the plan aimed at helping individuals receive “better, more joined-up care”, prime minister Boris Johnson said the plans build on the achievements of the national health system and local government during the pandemic. “We now want to build on these successes, joining up health and social care even more to deliver the best possible care, whether you want to see a GP quickly or live independently with dementia,” he said.

Also addressing the plans, health secretary Sajid Javid stressed the role of integration as “vital to stop people falling into the gaps between health and social care”. “Ensuring our health and care systems work in unison will mean we can support hardworking staff, provide better care to patients and deliver value for the taxpayer,” he added.

The paper sets out an approach to designing shared outcomes with “person-centred care” as a priority. The plan also aims to address problems such as the loss of information between primary and secondary care, as well as the duplication in use of resources and wasted patient time, as people are often asked for the same information multiple times, leading to delays in diagnosis or treatment, as well as poor resource allocation.

The white paper cites numbers around the current state of digitisation of health and care. More than 60% of NHS trusts have made good progress on that front, with 21% now considered to be digitally mature, according to the ideal scenario described in the What Good Looks Like framework, while 10% continue to rely heavily on paper. On the other hand, only 40% of social care providers are digitised and the yearly rate of improvement is about 3%.

Regarding specific technology-related aspects set out as part of the measures, the white paper outlines how the DHSC plans to make progress on digital and data, which are considered as key enablers of the integration strategy. According to the measures set out in the paper, a “core level of digital capability everywhere will be critical to delivering integrated health and care and enabling transformed models of care”.

The government sees the NHS App and NHS.uk, remote monitoring, and digital health apps as ways to “empower people to look after their health and take greater control of their own care”.

Read more about technology in health and social care

The government’s vision is that the NHS App will provide a personalised experience and encourage users to engage in preventive actions such as screenings, vaccinations and health checks. The idea is to also help people, families and carers to get an understanding of what tech might be helpful for them to remain independent and maintain their quality of life, such as smart home technologies.

In addition, the government wants to introduce shared health and care records that can be accessed by all citizens, caregivers and care teams by 2024. The starting point for this will be a consolidation of existing terminology standards by December 2022 – according to the DHSC, standards are key to integrated care delivery and a roadmap for standards development will be published.

According to the white paper, the final version of the Data Saves Lives data strategy for health and care, to be published in early 2022, will set out further details off when and how information can be accessed by individuals.

Also part of the measures is the recognition of the digital, data and technology profession in the wider change plans for the national health system; this would entail basic training in those areas for all health and care staff. “We will support all health and care staff to be confident when recommending digital interventions to patients and individuals using services, based on what we know works and what people want to access,” the white paper says.

Moreover, the white paper mentions the achievements of the NHS in the creation of the next generation of digital leaders in healthcare. NHS England, NHSX and partners created a 16,000-strong community of practice, dubbed AnalystX, for data professionals and analysts to share knowledge, learning and development.

As part of future developments around skills, the white paper noted a review into the digital skills of the social care workforce has been carried out by DHSC in partnership with Ipsos Mori and the Institute of Public Care and Skills for Care. Insights from the review will be used to build a digital learning offer to increase digital capability in that area.

Place-based organisations such as care homes are set to benefit from digital investment plans developed by Integrated Care Systems. Under the plans aimed at levelling up organisations in terms of their digital maturity, ICSs will establish a framework for data flows across all care settings and how to use technology for “person-centred and proactive” care.

Population health platform

Each ICS will implement a population health platform with care coordination functionality to support population health management and precision public health by 2025, the white paper says. In addition, it is expected that one million people will be supported by digitally enabled care pathways by 2022.

According to the DHSC, the measures around data and digital transformation outlined in the paper present an opportunity for greater transparency.

“We will look to introduce mandatory reporting of outcomes for local places, putting citizens at the heart of what we do,” it adds.

The announcement of the integration white paper is part of broader reforms around public health and social care. It follows the £5.4bn funding package to support adult social care reform, announced in December 2021, which includes a significant focus on the use of digital technologies to support people receiving care and caregivers.

Spanning across three years, the plans include initiatives to address the backlog of treatments and operations as a result of Covid, as well as hospital waiting lists, as well as the modernisation of the digital infrastructure of care homes.

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