By Sam Leonard, ARC England Director
The recent Government announcement of the plans for neighbourhood health services appears to be a positive step toward realising the long-term vision for integrated care. Local health leaders and councils are being encouraged to accelerate neighbourhood-level services by partnering with voluntary organisations and community groups. It’s good to see momentum, but it’s equally clear that the foundations remain shaky, particularly when it comes to social care and support’s role, funding and influence in the wider system.
The ambition outlined is for rollout nationally, not just in the most deprived areas. We welcome the stated commitment to partnership working, but the real question is:Â how is this going to be funded?
Reviewing the announcement alongside the NHS 10 Year Plan, it’s clear that neighbourhood teams could offer more holistic, continuous care to improve outcomes. However, there is no specific recognition of people with learning disabilities and autistic people, no new funding attached to the plan and little clarity on how these proposals will be resourced or implemented. Indeed, the NHS 10 Year Plan contains just one mention on page 36 that individuals with learning disabilities die on average 20 years earlier than the rest of the UK population.
Instead, the plan leans heavily on a handful of existing pilot projects, hoping others will follow their lead. Chapter 5 of ‘Fit for the Future’ is one of the few places in the entire 10 year plan where social care is mentioned with any substance. Even then, it’s a narrow view of social care that is framed largely through an NHS lens. There is no clear commitment to recognising social care as a strategic partner, nor to embedding our voices in decision-making structures.
Concerns about Integrated Care Systems
Our members and partners are expressing deep concerns about the ongoing reorganisation of Integrated Care Systems (ICSs). These changes risk excluding not only care providers but potentially local authorities themselves from Integrated Care Board (ICB) decision-making. Governance appears to be shifting to higher-level Strategic Combined Authorities centralising control and distancing it from local realities. The future of Integrated Care Partnerships (ICPs) remains unclear.
In short: direction without delivery mechanisms will not build a sustainable future. For neighbourhood services to succeed, social care must be at the strategic table properly resourced, genuinely valued and fully integrated into the system.
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