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Care Models 2020Integrated health and social care
Hammad KaziSenior ResearcherLaingBuisson
LaingBuisson
Relentless demand
16,500,000
17,000,000
17,500,000
18,000,000
18,500,000
19,000,000
19,500,000
20,000,000
20,500,000
21,000,000
-
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
2013-14 2014-15 2015-16 2016-17 2017-18 2018-19
Finished Consultant Episodes, 2013/14 - 2018/19
Less than 64 More than 65 Total
15% 10% 23%
EpisodesTotal <64 yrs >65 yrs
Source: NHS Digital
Relentless pressure
172180 184
191 197
0
20
40
60
80
100
120
140
160
180
200
£ bi
llion
Current public (historic series) Current private (historic series)Total current (new series)
Trends in expenditure on healthcare, UK 1997-2017
Source: ONS
£197.4bnCAGR 3.5% (2009--2017)
Nearly 9% of our GDP
Source: OECD
Where next?• CAUSATION – more money
• Demographics, 100 year life, behaviour, chronic diseases (e.g. diabetes, cancer, dementia, etc.)
• Communicable to non communicable
• CONNECTIVITY – more co-ordination, innovation• Technology, integration, payor and
provider, health and social care
• ACCOUNTABILITY – more transparency• Data and outcomes
The PM’s pledge to raise spending on the NHS by almost £34bn by 2023-24.
Causation - more money for the NHS
“For the first time, the National Health Service’s multi-year funding settlement,
agreed earlier this year, will be enshrined in law.”
Queen's Speech December 2019
Connectivity – integrating the systems
Multi-speciality
community providers (MCPs)
Primary & Acute Care
Systems (PACS)
Urgent & Emergency
Care Networks
Acute Care Collaborat-ions (ACCs)
Enhanced Health in
Care Homes (EHCH)
Sustainability & Transformation
Partnerships (STPs)44 footprints
Integrated Care Systems50 vanguard sites
Case study: West Midlands
STP footprints: • Birmingham and Solihull
ICS vanguard sites:• Modality Birmingham and Sandwell
• Solihull Together for Better Lives
• MERIT – Mental Health Alliance for Excellence Resilience, Innovation and Training
Case study: West Midlands
Circle Birmingham Hospital• Will contain two floors dedicated to rehabilitation
• Help accelerate the recovery of patients after musculoskeletal surgery
• Also offer neurological rehabilitation
• How can you track it• The regulator• Consumer feedback• Internal feedback
• Does it matter to investors• Different buyers• Different valuations
Accountability - Quality
iLaingBuisson – Care Monitor
The recent picture
But quality is not a moment in time
Source: iLaingBuisson Care Monitor
Factoring in social care
Social care is key to delivering healthcare to the population via the ICS model
Factoring in social care
In the last twenty years:
5 independent commissions. 4 white papers. 2 green papers
The PM aims to bring forward a proposal later this year with implementation of the action plan to be done “in this parliament.”
Factoring in social care
Source: LaingBuisson
Factoring in social care
Source: LaingBuisson
Factoring in social care
Source: LaingBuisson
Case study: Birmingham
135 Registered care homes
43% Nursing homes
57% Residential care homes
Source: LaingBuisson
Case study: Birmingham
% of Care Homes with corresponding CQC Overall ratings
68%
1% 2%
27%
60%
1% 3%
16%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Good Inadequate Outstanding Requires improvement
Birmingham England
Source: LaingBuisson
Case study: Birmingham
CQC overall ratings by registration types
66%
2% 2%
31%
70%
3% 3%
25%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Good Not yetInspected
Outstanding Requiresimprovement
Good Inadequate Outstanding Requiresimprovement
Nursing Home Residential Care Home
Source: LaingBuisson
Case study: Birmingham
Average occupancy rates
81%87%
82% 84%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Nursing Home Residential Care Home
Birmingham England
Source: LaingBuisson
• Partnering with the independent sector
• Technology and digital
• Integrated Care Systems
• Properly funded social care
The way forward
Thank you