health and social Care - Transcript

Title – Aileen Murphie, Director, National Audit Office

Date – 4 July 2018

Hi, I am Aileen Murphie, I am VFM director for local government here at the NAO and I am talking about our new report on the interface between Health and Local Government. This is a really key topic when we think about the way services need to be aligned around the needs of individuals. What we have seen over the last four or five years in our different reports is the fact that the integration of these services is slow and halting and progress is inconsistent.

So, what we’ve done is brought together our insights from a number of different reports and really boiled them down to two key challenges which government needs to address.

The first one is the financial challenge. Local government has seen its government funding drop by 50% since 2010 and it has had to cut adult social care provision and it is not keeping up with the demographic challenge of having more elderly people and more people with long-term health conditions in the community.

The NHS as we know has had small rises, but it hasn’t kept up with demand. The other thing is these two big systems have to work together well locally where one, the NHS, is command and control and the second, local government, is democratically accountable and organises its services according to local priorities.

So, we do see examples of where these services work well up and down the country. But the cultural and structural issues and the way that legislation works to inhibit integration need to be dealt with. So, what we are saying is here’s all the challenges. We point out the positive examples in the report where people are doing things well, such as in greater Manchester. But what we would say is this needs a strategic vision, it needs a long-term funding settlement not just for the NHS but for social care as well, as our boss said in the Guardian this week, Sir Amyas Morse.

So, I hope you enjoy the report I hope you think is says useful things and there is more information on the website.