Edward Argar
MP for Melton and Syston · Conservative · United Kingdom
“I will not keep the Committee long. I am very pleased to see the hon. and gallant Gentleman, the Minister, still in post, as this is a policy area that he has cared deeply about throughout his life. I share the broad support for the instrument expressed by the shadow Minister, my hon.”
“I appreciate it may be set out in the 2006 or 2025 primary parent legislation to these draft regulations, but if he can, I would be grateful for a little clarification. Finally, paragraph 10.1 of the explanatory memorandum refers to the legislation being continuously monitored.”
“I live in my patch and I know that there will be genuine local fury at the contempt this Government have shown for my constituents in approving a Leicester city land grab, which has cross-party opposition locally.”
“Lady was right to highlight in her remarks the importance of timely discharge from hospital as a key element of whether we can achieve that flow into hospital beds and have hospital bed capacity to allow an A&E department or emergency department to function.”
“That should not be a challenge; I suspect that that data is already extant in some part of the system. She is proposing a very moderate measure, which would pull all that together in one place, and allow it to be focused on and looked at in the round, rather than in disparate little penny packets of data.”
“Gentleman’s point, however, that with many of these things—both clinicians and coroners grapple with this—it is often complex to determine the actual most significant contributory factor. My hon.”
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“We launched a £3.6 million research for social care call to address important social care questions relating to dementia. The hon. Member for Oldham East and Saddleworth has taken a close interest in that, both in her previous shadow ministerial role and on the all-party parliamentary group on dementia, and I think that the APPG has called for evidence on social care impacts. We launched a highlight notice on dementia that invites ambitious dementia research applications; it signals to the community that dementia is a priority area for the NIHR. As we work across Government to finalise the outcomes of the spending review and look towards the spring, the House, the Government and the country need to retain a focus on this issue, which is one of the most testing challenges we face as a society.”
“There are many examples, but to give one, the “Well-being and Health for People Living with Dementia”, or WHELD programme developed an intervention to improve wellbeing for people with dementia in care homes and to reduce unnecessary prescribing of anti-psychotic drugs. In the 2021 spending review, as I have alluded to, we announced that £5 billion investment in health-related research and development. That reflects our commitment to support research, including in dementia. We have taken positive action over the past year, notwithstanding the pandemic, to lay the ground for further developments and further research. Within the National Institute for Health Research, we launched a new £9 million call inviting research proposals on the early detection of dementia using digital technology.”
“Often with research it is one step forward, two steps back, two steps forward, one step back, so the sustainability of investment and focus is vital if we are to make the breakthrough that we all wish to see. Dementias Platform UK has established technology-based networks to better understand how dementia starts and to support experimental medicine studies. As the APPG report recognises, in partnership with the Alzheimer’s Society and Alzheimer’s Research UK, people with dementia and their carers continue to be recruited via Join Dementia Research to take part in a range of important research. Through our National Institute for Health Research, we are supporting high-quality studies on preventing dementia through interventions targeted at known risk factors, service provision, care and care technology.”
“In that context, just one example is that my Department, alongside the Department for Business, Energy and Industrial Strategy, has announced a £20 million support package to help support early career researchers funded by charities. That will protect that pipeline of talent coming through the research system, to which Members have referred. We have a rich dementia research ecosystem and we need to continue to support it. Through the UK Dementia Research Institute, scientists have made huge leaps in understanding the mechanisms underlying disease progression, and researchers have developed potential new diagnostics and treatments. It is painstaking work. The hon. Lady will remember when the focus was very much on amyloids, and whether that would produce a route to that cure.”
“I find myself agreeing with the shadow Minister. When we put our minds to doing something as a society and a country, there are often no limits to what we can achieve, as we have seen. We must put the same focus on this issue. We recognise that the pandemic has caused problems across the sector and that many charities are facing difficulties just as their services are needed most. Medical research charities are a vital part of our life sciences ecosystem, and they provide significant research funding and training. Importantly, they amplify the voices of patients and their families in that process. Officials at the Department have been closely liaising with the medical research charities to better understand the impact of the pandemic on them and to seek to identify how we can work together to support their research and them.”
“Everyone with dementia should have meaningful care following diagnosis, including information on local services, access to relevant advice and support and what happens next. Carers should be made aware of and offered the opportunity for the respite and support they need. DHSC guidance is already available, titled “After diagnosis of dementia: what to expect from health and care services”. When we set out our dementia strategy, diagnosis will be a key element of that. Medical research charities have come up in this context, too, because it is not just about the big institutions—small institutions, academic institutions and charities are all playing their part in this space. I agree with Members in the analogy they drew with the vaccines and what can be achieved and what was achieved when there is an imperative to do it.”
“More than 15 million people aged between 40 and 74 are eligible for an NHS health check in England, and during such a check, individuals are made aware that exercise, healthy weight, healthy diet and reduced alcohol consumption help maintain a healthy brain, and we need to continue to emphasise that message and the support that is out there through those health checks. I think it was the hon. Member for Oldham East and Saddleworth who touched on early diagnosis—it is not just about focusing on research for a cure, but on diagnosis. Timely diagnosis of dementia, as with so many other diseases, plays a hugely important part in ensuring that a person with dementia can access the advice, information, care and support that can help them plan and to live well with the condition and remain independent for as long as possible.”
“I should take this opportunity—I fear I omitted to do so in my opening remarks—to pay tribute to Alzheimer’s Research UK, Dementia UK, the Alzheimer’s Society and the myriad local charities and groups that are working so hard to drive forward this agenda, and to support people with dementia and their families, as well as the research space. I add my tribute to that of the hon. Member for Denton and Reddish to the Greater Manchester research centre. Sadly it does not fall within my portfolio, but he and I might be dextrous in finding a reason within my portfolio that allows me to go and visit it with him jointly, which we would both enjoy.”
“I turn to prevention, including what the Office for Health Improvement and Disparities will do to help reduce people’s risk of developing dementia. The APPG report recommended that the new Office for Health Improvement and Disparities launch public information campaigns on dementia risk reduction. OHID is involved in the development of the new dementia strategy, which will include proposals on prevention and risk reduction. The concept of brain health as part of encouraging people to reduce their dementia risk—going to the point made by the hon. Member for Nottingham South—is being actively explored. OHID has been working with the Alzheimer’s Society and Alzheimer’s Research UK to review public-facing materials aimed at raising public awareness of dementia risk reduction.”
“Friend as I do, and watching his work as Chair of the Transport Committee, I suspect that he will not hold back in expressing his views on matters such as this, about which he is passionate. The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s broader commitment to support research into the most pressing health challenges of our time, including dementia. A number of specific points have been raised by the APPG and other Members. I will touch on as many as I can in the time available, but seek to leave five minutes for the hon. Member for Oldham East and Saddleworth, because I suspect she will want to come back on some of these points, given her work.”
“However, we have committed to invest at least £375 million in neurodegenerative disease research over the next five years. To the point made by the hon. Member for Denton and Reddish, we are working across Government to finalise outcomes from the spending review and to identify ways to significantly boost research on dementia. With that in mind, I turn to my hon. Friend the Member for Bexhill and Battle, who says that in this context, I will always have a friend in him. I always find that I do have a friend in him; I have known him for a long time. Without straying into territory more properly reserved to the Chief Secretary and the Chancellor, let me say that there is a joint ambition across Government to continue to drive this agenda forward. Knowing my hon.”
“Hon. Members raised a question about the devolved Administrations and working together. I think the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier), who is no longer in her place, mentioned the joint dementia research work. We are working with the Alzheimer’s Society, Alzheimer’s Research UK and Alzheimer Scotland. We are jointly funding that work to ensure that, notwithstanding other contexts in this House where we may have debates about our Union, we are genuinely working together to deliver a positive outcome. Increasing research spend takes time. I hope that hon. Members will recognise the impact that the past two years have had on the spending prioritisation, as we have had to focus to meet the immediacy of the covid situation.”
“I will return to other points subsequently, but let me turn to research and the moonshot that has been mentioned. The new dementia strategy will set out our plans to tackle dementia over the coming years. I try not to be partisan, so I pay tribute to the Scottish Government’s 2017 to 2020 dementia care strategy—I think it was their third—as well as the two related workforce programmes and a range of other measures. We can always learn from each other and best practice in different parts of our Union, and we should certainly be willing to do that in a space such as this. The hon. Member for Central Ayrshire (Dr Whitford) has kindly invited me to Edinburgh to see a range of things that she wishes to showcase to me. I hope that I will be able to take her up on that offer and also see my opposite number in Scotland, Secretary Humza Yousaf.”
“Members in the Chamber are as one in seeking one goal: the day we find a cure for dementia—or, at the very least, something that can delay it or treat it. While we wait for that day, it is important to recognise the point made about prevention by the hon. Member for Nottingham South (Lilian Greenwood). There is much that we do know about how people can help reduce their risk of dementia through lifestyle factors and a range of other things. They may not be exclusive, but there is an opportunity for people to take simple steps that help prevent or reduce the risk of getting dementia. We need to do more to spread that message and raise awareness of that in our society. I am grateful to her for making that point, because we want to reduce the number of preventable dementia cases.”
“However, I understand the entirely human reaction of people thinking, “Maybe I’d prefer not to know.” We need to continue that conversation. The second hugely important aspect is support and care for people with dementia and for those who care for them. While we seek to improve prevention and diagnosis as well as seeking that cure, we need to ensure that those living with dementia and those who are supporting them feel that they in turn are supported. We are determined to support those living with dementia to live the fullest possible life for as long as possible and to support those who care for them. Alongside that, the third element—in a sense, this is the crux of some of the speeches and the debate—is research into testing and diagnosis. While it is not often the case, I think that hon.”
“To return to the heart of the matter, perhaps one reason why people do not engage with it or talk about it—they may feel frightened—is that although with cancer we know that there are diagnostic tests and that every day we are making new discoveries that help increase the opportunity to find a cure and treat it or so that people can live longer and well with it, we are not there yet with dementia. I suspect that there is an element of people thinking, “Well, if I get the answer and nothing really can be done, do I want to know?” The short answer is that it is always better to know, because that allows the person to plan and have those conversations. Through knowing, they can also help advance that research.”
“While many thousands of people have dementia, we must not see it as an inevitable part of ageing. I will return to that. In the past 20 to 30 years, we have seen a breaking down of the taboo and unwillingness to speak about cancer, for example. As a society and as individuals, we talk much more in our national and individual discourse about cancer and what we can do to help prevent it, to treat it, and to make people feel less alone when they have a cancer diagnosis. We have made progress on dementia, but we still have a long way to go to raise that awareness and have that national debate. All hon. Members play a huge role in stimulating that debate, and today’s debate has helped to do that.”
“In common parlance and commentary, people talk about Alzheimer’s as dementia and dementia as a single disease, but she is right to talk about dementia as an overarching term for a variety of diseases. I will return to education and awareness-raising. ONS statistics show that in 2019 deaths attributed to dementia decreased for the first time since 2009, but they remained the leading cause of death, accounting for 12.5% of all registered deaths in that year. On the point that I was making to the hon. Lady, there are three key elements that we as a society and as a country need to look at. First, we need to raise people’s awareness and understanding of dementia. We want to have a society in which we all think and feel differently about dementia; one where there is less fear, stigma and discrimination and more understanding.”
“More than 850,000 people in the UK have dementia, and they are supported by a similar number of carers, many of whom are older people themselves, and we must never forget the debt we owe to each and every one of them. Of course, in a sense they do not see it as our owing them a debt. They do it out of love for their relatives and their friends, and that possibly even adds to the gratitude that we as a country should show them in recognition of what they do. Hon. Members have mentioned the Office for National Statistics data on deaths due to dementia and Alzheimer’s disease in 2019, and the hon. Member for Oldham East and Saddleworth made a very important point.”
“The hon. Gentleman is absolutely right, and I think he speaks for thousands across this country who will have had a similar experience during the course of the pandemic. We must never forget every one of the people lost during this pandemic, whatever medical reason caused that, and we must never forget the families and carers of those with dementia. As we have heard from hon. and right hon. Members—the hon. Member for Oldham East and Saddleworth talked about her mother, as did the hon. Member for Ealing Central and Acton (Dr Huq), who is no longer in her place—the challenge and the impact of dementia are huge. Dementia is a heartbreaking condition that, sadly, impacts many of us, or will do, either directly or through family and friends.”
“We recognise that that is welcome progress, as I am sure the hon. Gentleman would agree, but there is much further to go to recover fully from the pandemic’s impact on response times and to sustain that improvement. We welcome the service’s hard work and dedication and pay tribute to it for making those changes and delivering the significant improvements on which I am updating the hon. Gentleman.”
“I am pleased to reassure the hon. Gentleman that those measures have had an impact, and we are seeing improvements in response times from the peak of the pressures in December. Performance data for January, published today, shows significant improvement against all response time categories. Performance for category 1 calls—the most serious calls, classified as life-threatening—has largely been maintained at around nine minutes on average over the past several months, and improved to eight minutes and 31 seconds in the latest figures. That is despite a 19% increase in the number of incidents in that category compared with December 2019. Average responses to category 2 calls improved by more than 15 minutes compared with December, and the 90th centile responses to category 3 calls by more than two hours.”
“There is continuous central monitoring and support for ambulance trusts from NHS England’s national ambulance co-ordination centre, and we have also made significant long-term investments in the ambulance workforce. The number of NHS ambulance staff and support staff has increased by 38% since July 2010. More broadly, alongside the ambitious plan set out by the Government earlier this week, showing how we will invest the significant additional resources in outcomes for patients, just over a year ago we invested £450 million in A and E departments, to help mitigate the impact through increased capacity of infection prevention and control measures. I have regular direct meetings about discharge rates, and what we can do further to improve the flow of patients through hospital trusts within NHS England, with members of the taskforce on that.”
“That is focused on the most challenged hospital sites where delays are predominantly concentrated, with the 29 acute trusts operating those sites being responsible for more than 60% of the 60 million-plus handover delays nationally. That is targeted support for trusts that have particular challenges, either from the current situation or where there are underlying issues that we need to resolve. There is capital investment of £4.4 million to keep an additional 154 ambulances on the road this winter, and a £75 million investment in NHS 111 to boost staff numbers by just over 1,000, boosting call taking and clinical advice capacity that will better help patients at home, and better help triage those who genuinely need an ambulance and those who can be treated safely in a different context.”
“All trusts are receiving part of that funding, which will increase call handling and operational response capacity, boosting staff numbers by around 700. NHS England has strengthened its health and wellbeing support for ambulance trusts, recognising the pressure of the job on those working in the ambulance services, with £1.75 million being invested to support the wellbeing of frontline ambulance staff during the current pressures. NHS England and Improvement is undertaking targeted support for the most challenged hospitals, to improve their patient handover processes, helping ambulances to get swiftly back out on the road.”
“That partly reflects longer-term pressures, and I will move on to what we are doing to address those, but a large element of it is down to the specific circumstances of the past winter. The hon. Gentleman touched on the support in place to improve services, and asked what we are going to do about it, and what is being done to address these issues. He is true to form from when he shadowed me, as he will always set out the challenge and ask me what I am going to do or am doing about it, rightly holding the Government to account. Because of the pressures I mentioned we have put in place strong support to improve ambulance response times, including a £55 million investment in staffing capacity to manage winter pressures to the end of March.”
“To do that, we have to see discharges continue of patients who no longer meet the criteria to reside because they have recovered sufficiently, and the national discharge taskforce has done a huge amount of work on addressing that challenge. In recent months, we have seen the combined pressures of winter—the hon. Gentleman and I are familiar with those on an annual basis—and the impact of the omicron variant on the number of hospitalisations, which have not been as high as many feared and predicted, thankfully, but which have still had a significant impact on hospital beds. The combination of those factors, coupled with a high level of workforce sickness absence rates, including through positive covid tests—particularly over recent months with omicron—has created pressures that we would not expect to be systemic or built into the system.”
“Higher instances of delays in the handover of ambulance patients into A&E as a result of some of those factors, which I will turn to, are therefore leading to ambulances waiting for longer in queues and not being as swiftly out and about on the road and able to respond to calls. So there are knock-on effects there. One of the key challenges, which the hon. Gentleman will be very familiar with, remains the question of flow through an A&E and through a hospital. I am referring to the flow of patients out of ambulances into the A&E, who are then able to be treated in the A&E and discharged, hopefully, or who are then, in some cases, able to be admitted to a bed in a hospital ward.”
“I have asked for full information because I want to get back to her with as full an answer as I can, and I hope that he can convey that to her, if he speaks to her before I do. I am fully aware of her correspondence raising this on behalf of the family. Let me turn to ambulance response times and the reasons sitting behind some of the pressures. The ambulance service is facing a range of challenges that are impacting on its performance. The hon. Gentleman will be familiar with many of them, including the impact, still, of infection prevention and control measures not only in the ambulance service but particularly in A&E departments and wider acute clinical settings.”
“I use those statistics to illustrate the demand pressures, but I understand that behind those numbers, in every case, lies a human story—someone in need of care, someone worried and anxious, with friends and family anxious for them—so before I seek to go into the reasons, statistics and our plans and support, I want to say that I am sorry for patients who have suffered the impact of those service pressures. I want to be very clear that patients should expect and receive the highest standards of service and care. The hon. Gentleman highlighted some specific examples, including the case of Bina Patel. He is right that the right hon. Member for Ashton-under-Lyne (Angela Rayner) has raised that with me.”
“That is an increase of 11% on January 2020 and is one of the factors placing significant pressures on ambulance services, the wider NHS and the A&E departments to which they will take people when they feel that there is a clinical need. Although 999 calls tend to highlight the demand related to more serious medical conditions, many ambulance services are also responsible for 111 calls, which, in December last year, saw an increase of 15.5% compared with December 2019.”
“I am sure that the House will join me and the shadow Minister—the former shadow Minister; by force of habit, I keep calling him the shadow Minister. The hon. Gentleman and I have not always agreed, but we have been as one in paying tribute to all those who work in our ambulance services up and down the country. They have done an amazing job over the past two years, during the pandemic, to the very best of their ability. Of course, they do that amazing job day in, day out; irrespective of pandemics, they always do everything they can to support those who need them. The hon. Gentleman rightly highlights that the pandemic has placed significant demands on the service. In January 2022, it answered more than 800,000 calls.”
“I also know that he is a diligent reader of The BMJ , the Health Service Journal and various other excellent trade and specialist publications. It is a genuine pleasure to respond to him on this extremely important issue. It is a shame that the way in which the House allocates debates means that this is the last debate of the day, so there are few Members in the Chamber for it, because it is important. However, those we have in the Chamber are quality, and I look both at the shadow Minister—sorry, the former shadow Minister—and the hon. Member for City of Chester (Christian Matheson). As the hon. Member for Ellesmere Port and Neston highlighted, ambulance services have faced extraordinary pressures during the pandemic.”
“Reflecting the rest of the week, Mr Deputy Speaker. I am grateful to the hon. Member for Ellesmere Port and Neston (Justin Madders) for securing this important debate. In the same spirit, this is rather nice; it is like déjà vu: he used to shadow me at that Dispatch Box and in Committee. It is a pleasure to respond to his debate on this occasion. However, I must say that responding to the hon. Gentleman is a pleasure slightly tempered by caution on my part, because I know the depths of his expertise on this subject after his many years shadowing the Minister for Health—I think he shadowed my predecessors as well. He has great depth of knowledge in this space. He is and has been a notable advocate for our ambulance service and what it needs, and he looks forensically into those issues.”
“The trust has recruited additional paramedics and emergency medical technicians and upskilled its ambulance care assistants to blue light driving standard, thereby enabling the trust to deploy 269 additional frontline staff by the end of December. I close by reiterating the Government’s commitment to support the ambulance service. We retain regular contact with ambulance services, trusts and those delivering on the frontline to help to ensure that patients and the ambulance service receive the care and support that they need. I am grateful to the hon. Member for Ellesmere Port and Neston for bringing this matter to the House. Question put and agreed to.”
“The plan is comprehensive and covers a wide range of topics and details on the preparation for various scenarios. It includes several continuous improvement initiatives for support during the winter period. In summary, North West Ambulance Service is increasing its double-crewed ambulance capacity in line with winter funding arrangements, reducing conveyance to emergency departments and reducing the number of lost operational hours caused by day-to-day operational challenges. The trust has already seen significant improvements in the number of patients managed effectively through telephone advice, which helps free up ambulances to be deployed to where they are most needed.”
“Through its Every Minute Matters collaboration, which began three years ago, the trust has been working with other hospital trusts on improvements by working with senior leadership teams in hospital trusts to ensure there is a shared understanding of the risks of handover delays and a lack of ambulance resources to respond to patients in the community, to revisit action cards for operational commanders and, crucially, to recognise and thank staff for their continued reporting of delays and willingness to highlight problems to their managers or to the trust. The trust’s strategic winter plan has been activated and includes details of the measures in place to handle winter pressures and mitigate the effects of increased demand and a loss of capacity.”
“Three systems-led initiatives focus on the reduction of hospital handover times, the improvement of pathways for patients with mental health presentations and ensuring that alternatives to emergency departments—including access to primary care and other non-emergency-department pathways—are available to North West Ambulance Service in a timely and responsive manner. Hospital handover delays continue to challenge the North West Ambulance Service footprint.”
“Member for Ellesmere Port and Neston’s local trust received £6.2 million of funding, which it has used to increase its workforce for operational and contact centre teams. The trust is also engaged with regional NHS England and Improvement and commissioning teams to develop a six-point winter plan that seeks to address six key areas throughout the winter period. As it starts to get a little warmer and the daffodils start to come out, it is tempting for people to think that winter has passed, but winter pressures in the NHS can continue into late February and occasionally a bit beyond. I wanted to add that caveat.”
“At a time when the NHS is facing unprecedented demand, ambulance services are absorbing some of the increase in pressure. They are treating more people over the phone and finding other ways to reduce pressure in a clinically safe way. With clinical support in control rooms, the ambulance service is closing around 11% of 999 calls with clinical advice over the phone. That is far more than the 6.5% achieved in January 2020 and saves valuable ambulance resources for response to genuinely more urgent clinical needs. Let me say a little about North West Ambulance Service, if that is helpful to the hon. Gentleman—I know that he and the hon. Member for City of Chester take a close interest in their local ambulance service. Our support and investment has benefited the North West Ambulance Service. The hon.”
“I am grateful to the hon. Gentleman—I keep feeling tempted to say shadow Minister; he is a shadow Minister but he is no longer my shadow—for that point. He is right that when people ring 999 they should be given the appropriate clinical advice on whether they need to go to hospital, and if they do, an ambulance should be sent. I suspect that in individual cases a call handler may have made a tough clinical decision about the fastest way to get someone to hospital given the availability of ambulances, but the hon. Gentleman is right that if someone rings 999 and their condition is clinically deemed to require an ambulance and swift transfer to hospital, they should be able to expect an ambulance to come, assist them and take them to hospital.”
“It paints a vivid picture of a health and care system with more personalised care and greater transparency and choice, where early intervention prevents the most serious diseases, using the power of integration to give people the right care, in the right place, at the right time.”
“That means creating more opportunities for joint continuous development and joint roles across health and social care, increasing the number of clinical practice placements in adult social care for health undergraduates and exploring the introduction of an integrated skills passport to allow health and care staff to transfer their skills and knowledge between the NHS, public health and social care. The White Paper represents a further step in our journey of reform, building on the foundation laid in the Health and Care Bill, looking ahead to a future of health and care in this country with people at its very heart.”
“Finally, the White Paper shows the part that the workforce can play. The health and care workforce is one of the biggest assets that we have, and we want to make it easier for people working in health and care to feel confident in how the system works together in the best interests of those they care for and to feel empowered to progress their careers across the health and care family. To drive that, integrated care systems will support joint health and care workforce planning. We will improve training and ongoing learning and development opportunities for staff.”
“This year, one million people will be supported by digitally enabled care pathways in the comfort of their home. The White Paper sets out how we will open up even more ways for people to access health and adult social care services remotely. We will also support digital transformation by formally recognising the digital data and technology profession within the NHS “Agenda for Change”, and including basic digital, data and technology skills in the training of all health and care staff. Integrated care systems will be tasked with developing digital investment plans so that we can ensure that digital capability is strong right across the board. That means data flowing seamlessly across all care settings, with technology transforming care so that it is personalised to the patient.”
“Where several organisations are involved in one person’s care, there is a real opportunity to bring together data safely to create a seamless and joined-up experience. The White Paper reiterates our commitment to having shared records in place for all people by 2024, providing local people with a single, functional health and care record that everyone involved in care can access in a secure way. That will mean every professional having access to the key facts relating to a person’s condition, such as their diagnoses and medications. That will improve care, too, with professionals able to make care plans in full knowledge of the facts. We have seen a rapid expansion of digital channels in primary and secondary care services in recent years, but there is plenty more that we can do.”
“There are so many opportunities here. Closer working between primary and secondary care can allow care that is closer to home, keeping people healthy and independent for longer, and closer working between mental health and social care services can reduce crisis admissions and improve the quality of life for those living with mental illness. The White Paper sets out how we will get there, using the power of data to give local leaders the information that they need to establish new, joined-up services to tackle the issues facing their communities. Thirdly, we will make the best use of the huge advances in digital and data. We have seen throughout the pandemic how digital tools can empower people to look after their health and take greater control of their care—for instance, through the NHS app or remote monitoring technologies.”
“Integration supports transparency, and joining up NHS and local authority data means that we can provide local people with better insights about how their area’s health and care services are performing. With access to more information, they will be more empowered to make decisions about where and how they access care. There will be a new single accountable person for delivery of a shared health and care plan at local level. In practice, that could mean an individual with a dual role across health and care or a single lead for a place-based arrangement. Secondly, we will do more to join up care. At the moment, too many people are bounced around the system or have to tell their story multiple times to different professionals to get the care that they need, which is frustrating for people and frontline workers alike.”
“Our plans will bring together local leaders to deliver on shared outcomes, all in the best interests of their local communities, and encourage local arrangements that provide clarity over health and care services in each area, including aligning and pooling budgets. This arrangement has already been successfully adopted in several local areas. We have suggested a model that meets these criteria, and we expect areas to develop appropriate arrangements by spring of next year. Local NHS and local authority leaders will be empowered to deliver against these outcomes, and will be accountable for delivery and performance against them. They will be supported by a new national leadership programme addressing the skills required to deliver effective system transformation and strong local collaboration.”
“This White Paper has been shaped by the real-world experience of people, as well as by that of nurses, care workers and doctors on the frontline, drawing on some of the great examples of collaborative working we have seen, particularly during the pandemic. It will make health and care systems fit for the future, boost the health of local communities and make it easier to access health and care services. It is a plan with people and outcomes at its heart—no more endless form filling, no impenetrable processes and no more bureaucracy that sees too many people getting lost in the system and not receiving the care they need. First, we will ensure strong leadership and accountability, which is critical to delivering integration. Local leaders have a unique relationship with the people they serve.”