RECONSIDERING ACCOUNTABILITY IN AN AGE OF INTEGRATED CARE

RECONSIDERING ACCOUNTABILITY IN AN AGE OF INTEGRATED CARE BEN JUPP

BACKGROUND ‘Across the NHS we detect no appetite for a wholesale structural reorganisation’ NHS Five Year Forward View But also significant pressures for change With implications for accountability ©Social Finance 2015 2

ACCOUNTABILITY AND COMMISSIONING ‘The principal line of accountability for the NHS is through the commissioning line, following the flow of money from DH to NHS England to CCGs’ (Department of Health, 2014) ©Social Finance 2015 3

IMPLICATIONS OF NEW MODELS OF INTEGRATED CARE 4 • ‘New Models’ reflect wider developments in train • New models of condition management • HSJ Barometer found 70% of CCGs expected majority of GPs to join a single provider organisations in the next 4 -5 years before publication of Five Year Forward View • ‘A combined health and social care budget could be delegated to Multispeciality Community Providers’ Five Year Forward View • Reflects a wider shift in the bringing together of some ‘commissioning’ functions with provider functions – Internationally in health systems – Alzira, Accountable Care Organisations – In other services: employment support, schools, probation • Alongside significant financial pressures in social care and merging of health and care needs ©Social Finance 2015