On the NHS picking up the social care bill

The raging Brexit battles in Cabinet have produced an unlikely winner: Jeremy Hunt. This week a beleaguered Prime Minister and Chancellor finally bowed to the inevitable, approving a five year settlement allowing for an inflation-busting rise in NHS funding to tackle the raging health and social care crisis. And a ten year NHS settlement is on the cards – that’s good news for everyone in the business of forward planning.

England has a long and ignoble history of NHS re-organisations and, following the disastrous Lansley 2012 reforms, the eagle-eyed have been on the lookout for hints of the next change to come. Outright abolition of Lansley’s CCGs doesn’t seem immediately likely, but England could quietly creep back piecemeal to something resembling its pre-2012 structure. Mergers between the original 211 CCGs now leave us with 195 and counting. Fewer, larger commissioning bodies are back in fashion – whether they be STPs, ACOs or other acronym yet to be dreamt up by McKinsey.

A market engagement opportunity at Lincolnshire East CCG is an illustration in microcosm of the challenges NHS providers are facing.

As access to free local authority-funded social care has dried up, desperate patients and their relatives are seeking alternative outlets. There is an NHS scheme that provides free health and social care in the community, Continuing Healthcare (CHC) – and providers are unsurprisingly seeing demand for that scheme, and costs, increasing well above what demographic trends would predict.

Solving complex problems of demand management will rely more and more heavily on advanced analytics, but many providers don’t have the requisite systems expertise.

In Lincolnshire, Arden & GEM CSU – which manages CHC services on behalf of all four CCGs – has been trying to mitigate increasing costs for some time. Now the Lincolnshire CHC service is to be spun out as a new standalone business unit, hosted by Lincs East CCG and serving the entire county. The new business unit will require a fully managed IT solution to enable it to deliver the full range of CHC services; this week’s call for market engagement focuses on a CHC case management system to support services for adults and children.

Those with an interest could include Emis and Optum – the latter already provides some commissioning services to Lincs East. InterSystems provided the Lincolnshire-wide EPR which is currently being rolled out by the Lincolnshire STP, and in which Lincs East staff played a leading role.

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