Care boards are working hard to streamline processes, MPs are told
Integrated care boards across the country are “working hard” to streamline administrative processes and find efficiencies so that more people can access the care they need sooner, MPs have been told.
During a debate in Parliament in March, the then Minister of State at the Department of Health and Social Care, Stephen Kinnock, said the Government was committed to reducing the running costs of integrated care boards and to redirecting that funding to frontline services.
The Labour government’s 10-year health plan sets out that integrated care boards must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities, Mr Kinnock said.
“However, NHS England has been clear that, although transformation is required, it must be carried out with clear safeguards in place to protect frontline responsibilities. Legal duties in relation to NHS continuing healthcare must continue to be met. This means that running-cost reductions should aim to make administrative and corporate functions more efficient. They are not there to change funding for direct care or statutory duties.”
In response to questions from MPs; Mr Kinnock acknowledged that integrated care boards have worked intensively to strengthen their plans for 2025-26, focusing on areas where efficiencies and savings can be made.
“I thank NHS England for working with integrated care boards to monitor spend against these plans,’’ he said. “The Department is working closely with NHS England on how responsibilities will be delivered from April 2027 onwards, when—subject to the will of Parliament—NHS England will be abolished. Until those changes are made, the Department and NHS England will continue to carry out their respective statutory functions. In the interim, teams are increasingly working together closely under an interim joint leadership team, including on NHS continuing healthcare.”
Mr Kinnock said that addressing some of the issues MPs have raised about NHS continuing healthcare would require wider reform of the social care system, adding: “That is why Baroness Casey is chairing an independent commission into adult social care.”
He added: “In her recent speech, Baroness Casey rightly raised challenges with NHS continuing healthcare. We are carefully considering her reflections. I acknowledge existing tensions between integrated care boards and local authorities regarding NHS continuing healthcare eligibility decisions. Those decisions hinge on whether the support required by an individual is above the limits of what the local authority can provide. Integrated care boards must consult with the relevant local authority before making any decision about an individual’s eligibility for NHS continuing healthcare, putting individuals at the heart of the decision-making process.”
Mr Kinnock acknowledged that, in practice, it was not always straightforward to determine clearly who is responsible for meeting an individual’s needs, “so we are working with NHS England to better join up support between the NHS and local authorities, exploring areas where good joint working is helping to improve outcomes for people accessing NHS continuing healthcare”.
“Through the development of our neighbourhood health services, local authorities and integrated care boards are encouraged to consider how services can be reconfigured to focus more on prevention and early intervention, embedding new ways of working to set the direction of travel for future years.”
Mr Kinnock said there was a robust dispute resolution process in place for when a full assessment for NHS continuing healthcare has been undertaken and the person or people concerned disagree with the outcome.
He added: “First, an individual or their representative can ask for a local review from the relevant integrated care board. All integrated care boards should have developed a local resolution process that is fair, transparent and includes timescales. Where it has not been possible to resolve the matter locally, an individual may apply to NHS England for an independent review panel to review the decision. Finally, if the original decision is upheld and there is still a challenge, the individual can make a complaint to the Parliamentary and Health Service Ombudsman.”
“I also know that concerns have been raised about the relatively low number of individuals who are ultimately found eligible for NHS continuing healthcare after they have been referred for full assessment,’’ he added. “The threshold for initial referral by GPs, social workers and others is deliberately set low to ensure that anyone who may be eligible is fully assessed. For that reason, many individuals will not go on to receive NHS continuing healthcare. However, an assessment is also a gateway to other forms of NHS-funded support, such as NHS-funded nursing care and joint packages of care between local authorities and integrated care boards.”