Away from the past and to a sustainable future: how the UK's health and social care systems can be reformed to better align with the needs of today’s society
SMITH Ian R., SMITH Stephen K.
Health Service Journal
This paper explores the nature of the crisis affecting the health and social care systems, suggesting that they are badly misaligned with the needs of the society they serve, its ageing population, the prevalence of chronic ill health, rising demand and fall in funding. The paper diagnoses the reasons behind this misalignment and posits a solution: the introduction of integrated care organisations (ICOs) closely aligned to academic health and science centres (AHSCs). It argues that ICOs will remove the artificial and unhelpful boundaries between different parts of the healthcare service, and between health and social care. They will meet the needs of a population which is living longer and with more chronic conditions, move care away from hospitals, and promote prevention and parity of esteem between mental and physical health. Through alignment of these organisations with academic health and science centres, meanwhile, it will be possible to improve clinical outcomes and deliver precision medicine – and to sustain the UK’s position as one of the world leaders in genetic medicine. The paper also identifies the barriers to instituting such a change and explains how they can be overcome. It concludes with a step by step route map to a better care system, through ICOs and AHSCs. (Edited publisher abstract)