Integration accrue to other agencies such as the NHS or the 62 benefits system…’ ‘It is only with this greater focus on At the same time, integration should eradicate prevention and integration that both the NHS the sometimes false distinction between people’s and care and support can respond to the ‘health’ and ‘social care’ needs. Distinguishing between such needs all too often results in no financial pressures of an ageing population.’ statutory agency taking responsibility for the person 58 or service in question. As a result, we see too many (Earl Howe, 29th July 2013) people falling through the gaps and too many The importance of ‘integration’ was highlighted people’s needs escalating when they needn’t be. in a number of the joint health and wellbeing The provision of short-term wheelchair loans is just strategies and FOI responses. Under Section 3 one example of this. There is currently no clearly of the Care Act, ‘local authorities must ensure the defined duty for their statutory provision in England integration of care and support provision, including despite being included as an example of secondary prevention with health and health-related services, 63 59 prevention in the Care Act’s statutory guidance. which include housing’. It is particularly important Research demonstrates that they can prevent and to integrate ‘with partners to prevent, reduce or delay people’s need for health, social care and 60 delay needs for care and support.’ As the statutory support and reduce the level of need that already guidance notes: ‘Preventing needs will often be 64 most effective when action is undertaken at a local exists. This gap in provision is largely because of the level, with different organisations working together to false distinction between clinical and social needs for understand how the actions of each may impact on short-term wheelchairs resulting in a disagreement as 61 to where the responsibility should sit. the other.’ With almost a third of the FOI respondents Recommendation: highlighting their plans to work better with a range of other bodies (such as the NHS, faith > Devolved areas should seize the opportunity sector, police and businesses) or departments to eradicate the false distinction between (from housing to education), it seems local people’s clinical and social needs, and to authorities recognise the importance of joint return prevention savings to a single working in the context of preventing, reducing integrated budget. or delaying needs. > Local leaders should ensure prevention (in all The benefits of integration have been widely its forms) is a key aspect of all health and acknowledged for some time. However, there social care devolution deals going forward. have been some recent developments aimed at > Leaders within Greater Manchester and escalating the integration of health and social care. other devolved areas should ensure strategic These include the Better Care Fund and health and plans for the integration of health and social social care devolution developments in England. For care fully incorporate and prioritise prevention. example, Greater Manchester has been given control of a £6 billion integrated health and social care 56. NEF, Southwark & Lambeth Early Action Commission (November 2015) Local early action: how budget as part of its devolution deal and Cornwall is to make it happen: b.3cdn.net/nefoundation/a5845188d1801a18bc_3nm6bkn3b.pdf also developing a strategic plan for the integration of 57. LGiU (October 2013), Tracking your preventative spend: a step-by-step guide: lgiu.org. health and social care as part of its deal. uk/2013/10/16/tracking-your-preventative-spend-a-step-by-step-guide/ 58. Earl Howe (29 July 2013), publications.parliament.uk/pa/ld201314/ldhansrd/text/130729-0001. htm#1307296000176 The devolution of integrated health and social care 59. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.34) 60. Ibid. budgets provides a real opportunity to properly 61. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.32) invest in prevention. This is partly because both local 62. LGA (September 2015), Prevention: A shared commitment: local.gov.uk/ documents/10180/6869714/Prevention+-+A+Shared+Commitment+(1).pdf/06530655-1a4e- authorities and the NHS would benefit financially 495b-b512-c3cbef5654a6 from doing so. As noted by the Local Government 63. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.8) 64. McNulty, Carter and Beswick (July 2015), Putting the wheels in motion: Assessing the value Association: ‘It is (also) difficult for local authorities of British Red Cross short-term wheelchair loan: British Red Cross redcross.org.uk/~/media/ to build a business case to invest their scarce BritishRedCross/Documents/About%20us/BRC%20Wheels%20in%20Motion%20-%20July%20 resources in initiatives where the financial benefits 2015.pdf British Red Cross Prevention in action [email protected] 20 l l