Government’s integration White Paper could “medicalise social care”, say Mencap

The government has published a new White Paper which aims to better integrate the NHS and adult social care sector, bringing the health service and local government closer together to improve patient care.

Currently, the healthcare system means patients often find themselves having to navigate complex and disjointed systems, leaving those with multiple conditions (such as those with learning disabilities) feeling frustrated at having to repeatedly explain their needs to multiple people in different organisations.

It also means some patients face delayed discharge because the NHS and local authorities are working to different priorities in a way that is not as joined up as it could be, a problem which has put extra pressure on the NHS when it was already struggling with increased demand during the pandemic.

‘Levelling up’ health and social care across the country

The government hopes the new strategy will draw on the resources and skills across the NHS and local government to better meet the needs of communities, reduce waiting lists and help level up healthcare across the country. It will do this by providing:

• Better transparency and choice of care
• More personalised care, reducing the need for more expensive, invasive treatment
• Earlier intervention to ensure people access the right services at the right time
• Clear communication through a single digital care record
• Improved access to social care services through NHS data sharing
• Better treatment and management of diseases in the community
• Better NHS support to care homes
• Co-ordinating GP, specialist care, social care and local authority services
• Better value for money by reducing duplication and waste.

“People who use social care aren’t patients”

While the White Paper’s goals have been generally well-received, some organisations are concerned that the strategy doesn’t equally value social care as it does healthcare, and could lead to a “medicalisation of social care.”

Dan Scorer, Head of Policy and Public Affairs at the learning disability charity Mencap said: “We welcome the White Paper’s aspiration, but without adequate funding it is hard to see how true integration can be achieved.

“Social care doesn’t exist to relieve the pressure on the NHS. Integrating health and social care must be an equal partnership but the measures in the White Paper and the Health and Care Bill could lead to a medicalisation of social care.

“People who use social care aren’t patients – they are people who need support with daily living and accessing the community.

“The commitment to clear communication and information sharing is welcome, but systems need to be accessible or the health inequalities faced by people with a learning disability will become even worse. People are already struggling to navigate complicated booking systems, such as those for GP appointments.”

Inadequate funding for social care

The learning disability charity Hft has similar concerns, and Kirsty Matthews, CEO of the charity questions how successful the strategy will be when just £5.2bn of the Health and Social Care Levy – which totals £30.3bn – is earmarked for social care reform over the next three years.

She said: “Overall, we feel the announcement on integration is an important first step towards joined up health and care services which will promise better outcomes for everyone. We share the Government’s aspirations and would do all we could to engage with our partners to deliver a future system where this is realised to the benefit of those we are here to support.”

However, she added: “If the government are committed to delivering more personalised care, as set out in the White Paper, they must at the very least move away from medical language. Rather than referring to patients, they must recognise that individuals using social care are people who receive essential support with activities ranging from eating and washing to working and socialising.”