NHS and social care bodies take next step towards integrated health and social care for individuals

NHS England, the Local Government Association, Think Local Act Personal and the Association of Directors of Adult Social Services today (Thursday) formally invite health and social care leaders to help build a new integrated and personalised commissioning approach for people with complex needs.

Integrated Personal Commissioning is a new voluntary approach to joining up health and social care for people with complex needs. This proposal makes a triple offer to service users, local commissioners and the voluntary sector to bring health and social care spend together at the level of the individual.

Service users will be offered power and improved support to shape care that is meaningful to them. Local authorities and NHS commissioners, and providers will be offered dedicated technical support, coupled with regulatory and financial flexibilities to enable integration. The voluntary sector will be a key partner in designing effective approaches, supporting individuals and driving cultural change.

NHS England, LGA, TLAP and ADASS have therefore today published a joint prospectus inviting expressions of interest (this document is no longer available here but can be found on the National Archives website) from the voluntary sector, providers and commissioners in the IPC programme. The prospectus is supported by a guide to bring people up to date on the latest developments in making care more personalised and integrated.

Simon Stevens, NHS England’s Chief Executive said: “Kate Barker and The King’s Fund commission has today rightly described the need for more integrated health and social care for people who need care and their families. While the longer-term debate on how we get there is crucially important, so too is the need to deliver for people today. That’s why, for the first time since 1948, from next year Integrated Personal Commissioning means we will start offering fully combined health and social care funding, under the direct control of people using those services.”

ADASS President David Pearson said: “We have very much valued the opportunity to contribute to this immensely important initiative which will see personal budgets and Direct Payments – both of which an integral part of the social care offer in recent times – take a massive, decisive and encouraging step forward.”

The move follows a speech by Simon Stevens to the Local Government Association in July 2014.

Personal health budgets were introduced nationally in 2009 by the last government and have continued to grow – 636,000 people already have social care budgets and the NHS is learning from and building on this experience.

The budgets are already available for people who are eligible for NHS Continuing Healthcare. These patients have had a ‘right to ask’ for a personal health budget since April 2014 and this becomes a ‘right to have’ from October 2014. NHS care will continue to be free for patients at the point of use.

The closing date for IPC applications is 7 November 2014. They must be made jointly by one or more clinical commissioning group and local authorities, with at least one voluntary sector partner.

Local partners are expected to make a clear commitment to implementing new integrated funding models, making information and support available to their target population, and embedding personalisation in their organisations.

“Intertwining the benefits of personal budgets, integrated services and personalised approaches to users of the health and care services in these ways can do nothing but good for all the citizens we serve.”

To see the prospectus in full go to our Integrated Personal Commissioning (IPC) Programme page.


  1. Pearl Baker says:

    ‘Adult Social Care Service’ in West Berkshire state:

    Mental Health subject to section 117 of the 1983 MHA

    ‘Set down by the Department of Health, the criteria is graded into four bands (low
    Moderate, Substantial and Critical)

    WBC only operate the ‘CRITICAL’ band. they are one of a few operating the ‘CRITICAL’ level. NO chance of ‘integration’ here in West Berkshire.

    The NHS has to understand what agencies are involved in ‘Integration’ it is not open to discussion, it is a fact.

    The DWP, the GP, the CARER. NO LA involvement NO CPN Involvement
    Why are so many Mentally Ill people dying early? no support. The LA decide who will live and die, and that is a fact.

    NHS England has to face up to the fact, that you cannot ‘churn’ out these ever increasing instructions to the LA, CCG, who have no finances, intellect or understanding of what Care in the Community means.

  2. pauline says:

    If someone who has complex needs and cannot be looked after at home ,why can’t a three way charging plan be put in place. i.e. NHS SS and the person’s pension. That way the money will not be from one pot. If a person has reached the stage where they need nursing care their needs are usually quite high, way beyond domiciliary care.

  3. Paul Munim says:

    Our website connects people to their local community organisations. Many people do not realise that there are local community organisations in their area offering a wide range of free services and activities that can improve their health. We have found people spending money on purchasing services that they did not realise were available for free in their area through community organisations. We would welcome the opportunity to work in partnership with CCGs and local authorities to pilot this approach of encouraging people to use their local community organisations for services before accessing the NHS or Social Services. This could potentially be a very interesting way of reducing the demand now being experienced by hospitals and social services departments. We created our website because people told us they did not know how to contact their local community organisations but they do know how to contact their GP or Council, which is perhaps why these statutory services end up being the first port for call for everyone

  4. katie clarke says:

    What percentage of people with complex needs are not eligible for a personal health budget due to not receiving continuing care?
    What happens to this group of severely disabled people who still require 24hour support – some of which is medical – but the financial responsibility lies purely on social care with its reduced funding and the threat of closure of ILF looms ahead?

  5. Pearl Baker says:

    As a non recognised Carer who provides emergency crisis and daily encouragement I cannot see how ‘Integrated Personal Commissioning’ is achievable if Patients subject to section 117 of the 1983 MHA on an enhanced CPA are currently seeing their Care Manager Co-ordinators being removed, and not replaced.

    No Independent Advocates are being assigned to these patients, Carers being denied any support despite the new criteria (definition) in the Care Act 2014.

    Who is informing the patient on his current choices, direct payments, or personal budgets.

    Who is monitoring what it is really happening for the severely Mentally ill in the Community?

    CCGs and the LA are jointly responsible for the discharging of patients from section 117. This is the reality.

    West Berkshire Council and the Newbury District CCG have stated this is their criteria to discharge from section 117′

    1) Their mental health has improved, and their present situation is stable.
    2) They have the ability to function in their present situation and to cope outside hospital without danger to themselves and others.

    The CCG response to a FOI questionnaire on section 117 is as follows.
    ‘Discharge from aftercare under section 117 does not mean that free aftercare is stopped and patients may wish to stay in hospital as a ‘voluntary or informal’

    The DOH Code of Practice MHA 1983 state:

    ‘Where eligible patients have remained in hospital informally after ceasing to be detained under the Act, they are still entitled to aftercare under section 117 once they leave hospital’

    ‘Aftercare services under section 117 should not be withdrawn solely on the grounds that:

    27.21 Even when the provision of aftercare has been successful in that the patient is now well settled in the community, the patient may still continue to need after-care services, for example to prevent relapse.

    To Summarize the above we have severely mentally ill patients being discharged from section 117 while still receiving health and social care.

    We have patients placed into the COP for Property and finance, with no recognised Carer and No Independent Advocate.

    Many severely ill patients on an enhanced CPA are having their Care Manager Co-ordinators withdrawn.

    The above patients have no idea what their rights are to patient choice.

    This is the reality.