Concerns flagged over workforce and social care as Committee backs NHS reforms


A Report by the Health and Social Care Committee into the Government’s planned reforms of the NHS and social care is supportive of proposals, subject to accountability mechanisms on the safety and quality of care being built into legislation.

It has flagged up significant concerns, however, around the need for social care reform which requires a properly-funded long-term plan, and workforce planning. 

The inquiry into the White Paper, Integration and Innovation: working together to improve health and social care’ concludes that the creation of Integrated Care Systems (ICSs) throughout England has the potential to improve the delivery of care services for patients.

The Report welcomes a commitment from the Secretary of State to act on the Committee’s suggestion to include in the Bill provisions for independent ratings of the ICSs, to be carried out by the Care Quality Commission.

The Government proposes to give a legal form to ICSs. Each ICS will comprise an Integrated Care System Body responsible for developing a plan to meet the health needs of the local population and an Integrated Care System Health and Care Partnership responsible for supporting integration and developing a plan to address health, public health and social care needs of the area they cover. 

MPs have called for a more detailed framework that sets out the roles and responsibilities of both the NHS Body and the Health and Care Partnership, with clear lines of accountability to ensure success.

On social care, the Committee urges that new legislation should impose a duty on the Secretary of State to publish a 10-year plan with detailed costings, within six months of the Bill receiving Royal Assent.

Funding should be at the levels set out by the Committee in its ‘Social care: funding and workforce Report’. The absence of a fully funded plan for social care has the potential to destabilise Integrated Care Systems and undermine their success, and without secure long-term funding problems that have bedevilled the care sector for decades would not be resolved, say MPs. 

The Health and Social Care Committee says the starting point for the social care funding increase must be an additional £7 billion per year by 2023/24.

At a Liaison Committee meeting, the Prime Minister committed the Government to producing a 10-year plan on social care later this year.

Rt Hon Jeremy Hunt MP, Chair of the Health and Social Care Committee, says: “We broadly support the proposed changes provided the new Integrated Care Systems are held accountable for the quality and safety of care delivered through transparent CQC assessments. But we remain concerned about glaring omissions, including the lack of social care reform, and a much-needed overhaul of workforce planning.

“If such issues are addressed the government has an opportunity to deliver a post-pandemic watershed '1948 moment' for the health and care system, matching the significance of the year the NHS was founded. But if they are not, it will be a wasted opportunity to deliver the truly integrated care required by an ageing population.”

Responding to the report, Richard Murray, Chief Executive of The King’s Fund, says: “By sweeping away clunky competition and procurement rules, the government’s NHS reform plans could give the NHS and its partners greater flexibility to deliver joined-up care to the increasing number of people who rely on multiple different services. Whether these benefits are realised will critically depend on how the reforms are implemented.

“However, these reforms only deal with part of the problem facing health and social care. The government has yet to say how it will tackle staff shortages, redress deep-seated health inequalities, or bring forward long-overdue reform of the social care sector.  

“As part of its inquiry, we told the Committee that the government’s White Paper proposals to improve workforce planning are wholly inadequate. Reformed services are no good without the staff to run them. As staff emerge from the Covid-19 pandemic physically and emotionally drained, there is an increasingly urgent need for a fully funded workforce strategy to increase recruitment and tackle staff stress and burnout. 

‘The reforms will place greater power in the hands of the Secretary of State, but ministers should be careful what they wish for. Political expediency should not trump clinical judgement so we support the Committee’s call for greater clarity on why these new powers are needed and how they will be used.”

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