Creating a better care system: setting out key considerations for a reformed, sustainable health, wellbeing and care system of the future
ERNST AND YOUNG
In this report, commissioned by the Local Government Association, a journey towards better health and care for individuals is set out; driven by local system leaders and supported by a more empowering and enabling system. The report has been developed through: a review of existing literature published by partners, charities and research organisations; four workshops with the LGA and partners to define the vision, understand the system barriers from a range of perspectives and describe the required changes; and further discussion with regional contacts and the Health Transformation Task Group to sense check that barriers and key considerations are locally relevant and reflect the experience in local areas. Section 1 sets out a vision for better care and support, arguing that a reformed system needs to deliver: better health and wellbeing more equally enjoyed; better choice and control for all; better quality care, tailored for each person; and better outcomes for each pound spent. Section 2 focuses on key barriers preventing the achievement of a reformed system. These include: creating dependency through the way treatment is provided; chronic underfunding of the system and a lack of capacity to transform; fragmented commissioning incentivising treatment over demand management; and national regulations that disempower local areas. Section 3 sets out four steps to better care, which are: put people in control; fund services adequately and in an aligned way; devolve power to join up care, support and wellbeing; and free the system from national constraints. The report concludes that collectively these steps will enable localities to address challenges, deliver a better system and ultimately drive better outcomes and greater sustainability for all.