One Budget, One Care: Should the UK adopt a single health and care system?

One Budget, One Care
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Date/time
Date(s) - 25/06/2013
4:40 pm - 6:30 pm

Location:
Strategic Society Centre


Speakers at this event comprised:

  • Rt Hon. Stephen Dorrell MP, Chair, Health Select Committee
  • Dan Gascoyne, Assistant Director for Corporate Policy, Strategy and Partnerships, Essex County Council
  • Matthew Flinton, Director of Legal and General Counsel, Bupa UK
  • James Lloyd, Director, Strategic Society Centre
  • Chair: Andrea Sutcliffe, Chief Executive, Social Care Institute for Excellence

Twitter hashtag: #onebudget

Health and Wellbeing Boards were created to drive the NHS and local government toward joint commissioning of services for their local population.

The government wants Boards to take a comprehensive, holistic approach to defining need, and to foster innovative solutions based on local ‘assets’.

Already, however, a much more revolutionary vision is emerging for Health and Wellbeing Boards: as the key to creating single budgets for most health and care spending in the community.

Only with one budget, it is argued, can the full benefits of ‘integrated care’ be secured:

  • ‘Health spending’ invested in cost-effective, community-level prevention including specialist housing;
  • Efficiency savings from a single commissioning process;
  • Truly integrated providers of health and care capable of treating the ‘whole person’;
  • An end to ‘cost shunting’ between health and care services and budgets;
  • A better experience for service users through single assessments.

In this way, proponents believe a ‘one budget’ approach will allow Health and Wellbeing Boards to dissolve artificial differences between what are ‘health’ vs. ‘care’ needs, who provides services to meet need and who pays for them.

This event will therefore explore:

  • Integration choices – can real efficiency savings be achieved from joint commissioning, or will they only really be possible from full merging of health and care budgets to enable a single budget with a single commissioner?
  • Budget pressures – is integration of health and care budgets made easier, harder or inevitable by the unprecedented budget pressures confronting the health and social care systems over the next decade?
  • Implementation – how would a single health and care budget be created from the new structures in the NHS and local government? Do Health and Wellbeing Boards provide the key?
  • Defining need – would a single budget for health and care retain distinctions between health and care needs, or just focus on commissioning services for outcomes?
  • Personalisation – what does the ‘one budget’ approach to health and social care mean for the personalisation agenda, and the aim to give social care users choice and control?
  • Paying for care – what, if any, services would individuals be charged for under a single health and care budget? Would social care still be means tested?
  • Capped costs – what do radical models of integrated commissioning and funding mean for the government’s plans to cap people’s care costs?

This event is part of a project on the future of social care, made possible by the kind support of Bupa UK.

The slides from this event can be viewed below.

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