Integration can only happen with single budget for health and social care

The NHS should move towards a single commissioning budget for health, social care and social housing if it is to achieve full integration of services, a former health secretary has said.

Mr Dorrell: ‘The objective I will be looking from the Bill process is the encouragement and development of properly integrated, single budget commissioning.'

At a Westminster Health Forum event on the Health Bill in central London on Tuesday, Stephen Dorrell (Conservative; Charnwood, northern Leicestershire) said integration of services is key if the NHS is to meet efficiency challenge and improve quality.

But he said the only way of this could be achieved is if the NHS, social care and social housing budgets are pooled with one single commissioner of services locally

He said: ‘The objective I will be looking for out of this Bill process is the encouragement and development of properly integrated, single budget commissioning.

‘Until we have one commissioner fashioning the services that are required... I don’t believe we will get the integrated services that the service users need.’

David Stout, director NHS Confederation PCT Network, warned that while the suggestion is a ‘nice idea’ the NHS is ‘miles away from achieving it’.

He said the move would be ‘politically contentious’ so the likelihood of it being legislation is ‘pretty slim’.

But Mr Stout did warn that the government has ‘disintegrated commissioning’ in the way it has carved up responsibility for the commissioning of services.

He said: ‘We have got local authorities responsible for public health for children over six, with have commissioning board responsible for children under six, we have commissioning groups responsible for local childcare services and the NHS Commissioning Board responsible for specialist child care services.

‘That is a complicated, fragmentation of commissioning. It needs to pull together.’


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