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Poor data sharing is one of the main reasons why the integration of health and social care in the UK has been slow and “less successful” than planned, according to a report by the National Audit Office (NAO).
The report, which examines the government’s plans for integrated health and care services by 2020, funded by the £5.3bn Better Care Fund, found that the programme had failed to meet many of its targets.
“The fund has not achieved the expected value for money, in terms of savings, outcomes for patients or reduced hospital activity, from the £5.3bn spent through the fund in 2015-16,” the report said.
As a result, the target of achieving an integrated health and social care system by 2020, which includes integrated digital care records available at the point of care, is at “significant risk”, it said.
The report cited three longstanding barriers that had caused problems for the integration agenda, including “misaligned financial incentives” and “reticence over information sharing”.
The NAO said the problem was at national level and added: “Local bodies found the regulatory framework confusing and there was insufficient support from the centre to tackle information governance issues.”
A review by the Local Government Association (LGA) last year found that the problem does not lie with policy, as there were “no policy constraints preventing information sharing”.
But the NAO found that local health and care organisations were “still unsure of the legal requirements for data sharing and felt this was still acting as a barrier”.
“They found it difficult to track patients through different care settings, compare costs and establish whether integration was saving money,” the report said. It pointed out that one-third of areas were still not using the NHS number as the primary identifier for patients – despite this being a requirement.
NAO head Amyas Morse said the investigation showed that “integrating the health and social care sectors is a significant challenge in normal times, let alone times when both sectors are under such severe pressure”.
He added: “So far, benefits have fallen far short of plans, despite much effort. It will be important to learn from the over-optimism of such plans when implementing the much larger NHS sustainability and transformation plans.
“The departments do not yet have the evidence to show that they can deliver their commitment to integrated services by 2020, at the same time as meeting existing pressures on the health and social care systems.”