Safety recommendation
HSIB recommends that the Department of Health and Social Care conduct an integrated review of the health and social care system to identify risks to patient safety spanning the system arising from challenges in constraints, demand, capacity and flow of patients in and out of hospital and implement any changes as necessary.
Response:
The Department accepts the recommendation. The Department keeps health and social care performance under continuous review, informing a wide range of interventions to improve patient flow and help support waiting time performance, as set out in the response to recommendation R/2022/196 (above).
This work continues to consider longer term constraints, demand, capacity in relation to the flow of patients in and out of hospital.
The Department recognises the important of an integrated approach across the health and social care system. The Health and Care Act 2022, which received Royal Assent on 28 April, was a milestone in the recovery and reform of how health and care services work together, supporting a more joined up system. The Act ensures that every part of England is covered by an Integrated Care System (ICS), which brings together the NHS, Local Government and wider system partners to empower them to put collaboration and partnership at the heart of planning. The Act put a framework in place to improve integration and collaboration across the healthcare system and to help remove barriers in the discharge process from hospital, reducing unnecessary delays throughout the patient pathway.
Through this Act, two statutory bodies were created within each ICS – an Integrated Care Board and an Integrated Care Partnership. These new arrangements put shared leadership and collaboration between the NHS, local government, and other partners at the heart of strategic planning.
An integrated approach to person-centred care will bring together local actors in health and social care, alongside local and voluntary partners. Potential significant health benefits to patients include increased independence, improved quality of care, reduced preventable (re)admissions into hospitals and higher patient satisfaction.
Actions planned to deliver safety recommendation:
- ICS setup as set out in the H&C Act 2022 and ICS setup already being implemented.
Response received on 24 October 2022 and updated on 1 October 2024 below:
As set out in the response to R/2022/196 above, there will be a wide-ranging investigation that will provide an independent and expert understanding of the current performance and the challenges facing the healthcare system, and ensure that a new 10-year plan for health focuses on these challenges. This is due to publish next spring.
NHS England and the Department of Health and Social Care continue to collect a range of data across sectors to keep patient flow along NHS care pathways and into social care and community settings under continual review, highlighting bottlenecks in the system and informing measures to address these. Ministers are working closely with the NHS and the social care sector to improve performance and meet regularly to review progress.