NHS England chief executive, Simon Stevens has set out plans for a new Integrated Personal Commissioning (IPC) programme in a major speech at the annual conference of the Local Government Association.
The proposals will offer local councils across England a radical new option in which individuals could control their combined health and social care support.
Speaking at the LGA conference in Bournemouth, Stevens set out plans for the new IPC programme, which will for the first time blend comprehensive health and social care funding for individuals, and allow them to direct how it is used. Four groups of high-need individuals are likely to be included in the first wave from next April 2015, although councils, voluntary organisations, and NHS clinical commissioning groups (CCGs) may also propose others. These are:
- People with long term conditions, including frail elderly people at risk of care home admission.
- Children with complex needs.
- People with learning disabilities.
- People with severe and enduring mental health problems.
At the same time, voluntary/third sector organisations will be commissioned locally to support personal care planning, advocacy and service ‘brokerage’ for these individuals enrolled in the IPC programme. This new approach builds upon, but is in addition to, the constructive joint work now under way locally on the Better Care Fund. It also extends and combines current work on ‘year of care’ NHS commissioning, personal budgets in ‘continuing care’, and the early experience of 14 ‘integrated care pioneers’.
In his speech at the conference, Simon Stevens said:
“Patients, service users and carers have the biggest interest in getting things right, but they can only do so if we give them real power to shape their own care.
“If Beveridge was alive today he’d clock the fact that – given half a chance – people themselves can be the best ‘integrators’ of the health and social care they are offered. “We need to stop treating people as a collection of health problems or treatments. We need to treat to them as individuals whose needs and preferences should be seen in the round and whose choices shape services, not the other way round.
“That’s the big offer the NHS increasingly has to make to our fellow citizens, to local authorities, and to voluntary organisations. We need a double N in ‘NHS’ – a National Health Service offering more Neighbourhood health support.”
Under the new IPC programme, a combined NHS and social care funding endowment will be created based on each individual’s annual care needs. This will blend funds contributed from local authorities and NHS commissioners (CCGs and NHS England). Individuals enrolled in the programme will be able to decide how much personal control to assume over how services are commissioned and arranged on their behalf. NHS care will in all cases remain free at the point of use, and available according to individual need. NHS England will now work with partners in local government, CCGs, patient groups and the voluntary sector to develop an IPC Prospectus which will be published at the end of July. This will formally invite local expressions of interest in jointly developing and participating in the IPC programme from April 2015. NHS England will provide technical support to develop projects, and fund independent evaluation. Wider scale rollout of successful projects is envisaged from 2016/17. Experience with pilots have shown that this approach has the potential to join-up services and funding at the level of the individual, for people who often need multiple services. It gives control to those people who have the biggest interest in getting things right – people receiving services and their carers. It often brings in peer support, and is a source of innovation and expertise on what really works in practice. It allows people to flex support over the year as conditions get better or worse, and brings different expertise to the care planning process.
Commenting on the proposals, Julie Stansfield, CEO of In Control, said:
“In Control welcomes this announcement and is particularly pleased to hear of the emphasis on putting integration, choice and control into the hands of people themselves. Those with long-term and continuing health care needs, and their families, really do have the greatest interest in getting the NHS support right at the point of delivery – exactly what the NHS was about in the first place.
“We do of course have concerns about how such a significant and ambitious system and culture change can be implemented. I am sure that with this new policy we will see a raft of new roles such as project managers, coordinators and local ‘champions’ but it’s not these staff that will make a difference on the ground. I really do hope that Simon Stevens’ message about the importance of peer support becomes a reality as this is what will be the greatest lever for change. If there is the right investment in people with ‘lived experience’ and peer networks such as Partners in Policymaking from the outset to help drive this change and serious power shift, then the NHS may just pull this off.”
