Experts are warning that the integration of health and social care - which has been a key policy theme for many years - is now at risk because of mounting pressures on services.
The NHS Confederation, Local Government Association, Association of Directors of Adult Social Services (ADASS) and NHS Clinical Commissioners have published a report outlining a "whole system vision" for change that centres on forming care around the needs of individuals, in the hope of accelerating action on integrating health and social care.
According to Stepping up to the place: The key to successful integration, redesigning health and social care services around the needs of individuals in a place "provides the best opportunities to improve people's health and wellbeing including closing health inequalities and helping to bring financial sustainability."
However, it describes an unprecedented pressure on funding that has weakened the foundations of the whole health and social care sector, putting at risk plans to improve care, and calls for an end to the status quo through faster integration of services to meet the needs of a growing number of patients with increasingly complex health needs.
In the first instance, national leaders must redress the short-fall in funding, particularly in public health and community services as demand outstrips resource, it says, and also underscores the need for a cultural shift away from focusing on services only when people are ill or have critical social care needs, to improving public health.
Redirection of investment across health and care services to prioritise public health and community services, alignment of workforce planning across local government and the NHS to better meet the needs of local communities, and shared systems including jointly identifying and sharing risk are also essential to successful integration of the two factions.
"This report sends a clear message that to improve the standard of care that we deliver to people we must better integrate our health and social care services," said Stephen Dorrell, chair of the NHS Confederation. "We need to make sure we are utilising all the collective resources of a 'place' to benefit our local communities. There is now a real urgency to deliver on this ambition. Our priority now must be to turn rhetoric into action."
"We've made great strides over the last few years to bring together services to get better services, better health and wellbeing outcomes and better use of our resources, but we need to go further and faster in order to address the demographic and financial challenges facing us," added Councillor Izzi Seccombe, Chair, LGA Community Wellbeing Board.
"Through our shared vision, we are supporting local political, clinical and community leaders to ensure that integration moves from the sidelines to the mainstream."