The new health and care landscape

The Health and Care Bill is on its way through the parliamentary process, very quietly. It will, if enacted, change the face of the NHS organisations we work for quite fundamentally. The integrated care systems emerged from the sustainability and transformation partnerships and are thus designed from the bottom-up, rather than the other model of top-down imposition. Does this mean they are better? We shall have to see...Essentially, the Bill as proposed, has removed the element of competition between providers and the key words, which relate to this brave new world, are ‘collaboration’ and ‘integration’.

The opportunity for development of the system was seen clearly during the pandemic, when local organisations worked effectively together across boundaries to deliver what the population and the emergency needed. In the cool light of day, can we rely on those collaborations to deliver what is promised and necessary? Health and Social Care are complicated and the years of competition between organisations have led to very individualistic attitudes to other providers, which may take some time to change. 

The culture in healthcare is very much people based; an essential element is having relationships with others in order to effect an action, which may be slightly outside the ‘norm’. As demonstrated also during the pandemic, that there was no relationship between healthcare organisations and care homes, so rather than discussion taking place as to the possibility of patients with COVID-19 being discharged from acute care, and appropriate solutions being found, patients were discharged in the panic and a devastating situation ensued.