Government failure to fund and coordinate preventive care ‘laid bare’

Key Commons committee says councils need urgent funding to help NHS bring emergency hospital admissions down.

Councils need urgent funding to engage with work to bring emergency hospital admissions to hospital down a key Commons committee says – with the message backed by the LGA.

The Public Accounts Committee (PAC) calls on NHS England to consider the impact of funding and demand pressures in social care on emergency admissions – where a quarter could be avoided with more effective care in the community.

PAC says some 1.5m of the 5.8m emergency admissions over 2016-17 could have avoided emergency admissions in 2016–17 if hospitals, GPs, community services and social care had worked together more effectively.

But the report references a lack of investment by the NHS in these services, with rising demand on adult social care and limited council finances said to be “particularly worrying”.

PAC chair, Meg Hillier MP said the report “laid bare” the consequences of Government’s failure to properly fund and coordinate preventive health care and social care.

“The benefits of work to reduce the impact of emergency admissions will inevitably be limited until hospitals, GPs, community services and social care work better together to drive down the level of avoidable admissions.

NHS England and NHS Improvement must take a lead here and move swiftly to better understand the stresses across the health and social care sectors and their implications,” said Hillier.

“A priority must be to properly identify the impact of measures intended to reduce emergency admissions and explain how this information will be used to target scarce resources effectively.

The financial challenges facing the NHS and adult social care are well-documented and it is critical that taxpayers’ money is spent on what works best,” she said.

PAC recommends that NHS England should identify gaps in primary and community health care and set out how it intends to address them, saying the impact of pressures on social care provision on emergency admissions should inform discussions with both the Ministry of Housing, Communities & Local Government and HM Treasury ahead of the green paper on future funding for social care.

Though the report acknowledges NHS England as using various interventions including new care models and the better care fund cut emergency admissions.

But this, says PAC, is “too piecemeal and “varies regionally” with neither NHS England or NHS Improvement knowing what is the most effective approach.

The report says NHS England “has not systematically engaged with the voluntary sector to understand fully the importance of its support in reducing emergency admissions”.

Responding to the report, chair of the LGA community wellbeing board Cllr Izzi Seccombe  said councils need urgent funding to invest in effective prevention work – with the funding gap in social care set to exceed £2bn by 2020.

“Essential prevention work and early intervention services are also being hampered by a £600 million reduction in councils’ public health budgets by central government between 2015-16 and 2019-20,” Seccombe said.

“The LGA is calling for these reductions to be reversed by the government, which will help to further reduce NHS pressures and costs increasing,” she said.”

Last month, PAC said government should devise a “credible plan” by the end of this year establishing a sustainable adult social care system and implement it quickly.

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