Efficiency opportunities through health and social care integration - interim report

While there is general agreement that the current system of health and care is unsustainable, there is still debate as to how the system might be improved.

The LGA launched this project to provide evidence of the efficiency opportunities in the health and care system, so helping leaders to release much needed resources and inform the debate as to what a more sustainable system might look like in the future.

Findings emerging from this study have been identified by working alongside practitioners and clinicians in the participating areas.

The evidence gathered to date suggests that overall savings of 7-9% of the budget areas assessed in this project could be realised.

Other key findings include:

 The role of preventative services is key to any future model of health and care. When analysing service users at the front door of the local authority 25%-40% of users would have benefited from preventative services which they did not receive. Of those cases classified as ‘avoidable hospital admissions’, 30% would rely on early identification and prevention;

 For about 14% of people who are admitted to an acute hospital there were missed opportunities, in both primary and community services, to undertake actions that might have avoided the need for the hospital admission. Additionally around 8% of individuals could have had their admission avoided by social care services;

 22% of non-elective beds in the acute hospital could be freed up by using alternate settings of care – predominantly at home with social care support or community services;

 For 21% of the people who were discharged from hospital onto pathways involving a package of care, a preferable pathway was identifiable that could have delivered better outcomes for the service user at lower cost. Given that a significant subset of these pathways results in long term residential placements this is of particular significance to the system. Practitioners believed that 59% of long term residential placements via the acute hospital could be delayed or avoided;

 There is scope within community services to develop a better skill mix of practitioners and clinicians with front line care workers, that would make better use of the resources available;

 During this work local practitioners have analysed case notes and identified significant numbers of pathways where they believe better outcomes could be achieved for services users. In more than 90% of these cases the alternatives recommended already existed.

 Combined procurement of continuing health care and local authority placements could lead to lower costs;

 The process of integration between Health and Social Care needs a clear transformation plan which is not solely about a structural change, but focusses on improved outcomes for service users and patients;

Nine key themes which local leaders may need to address to enable effective integration are highlighted and discussed in the report.

Read the full report here: http://www.local.gov.uk/documents/10180/11779/Efficiency+Opportunities+through+health+and+social+care+integration/ddec99af-bf5e-4a03-8581-4416861330c8
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