Poor health and social care integration
Lack of a fundamental shift towards collaborative, integrated system-wide change in health and social care.
1,185 items
15 sources
10 inquiries
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
100match
#28 - Ensure alignment of Integrated Care Systems reforms with local government and adult social care
The Department for Health and Social Care must ensure that the ongoing reforms and cuts to Integrated Care Systems and Integrated Care Boards are aligned both with wider reorganisation of local government and with necessary reforms to the adult social care sector. (Recommendation, Paragraph 99)
Matched on
terms: care, health, social
Committee recommendation
100match
#30 - Strengthen accountability frameworks for health partners to ensure full integration into the SEND system.
The limited engagement of health services in the SEND system stems from a lack of robust and enforceable accountability mechanisms. Despite being a critical enabler of positive educational outcomes for children with SEND, health services are not held to the same standards of responsibility as education providers. To deliver on the promise of inclusive education, the Department for...
Matched on
terms: care, health, integration, social
Committee recommendation
100match
#4 - Require NHSE and Department to set out plans for elective care digital transformation and IT connectivity.
We are not confident that the Department is being realistic about the immense effort needed to reduce NHS elective care waiting times, and see a significant risk that digital solutions are being treated as a ‘cure- all’ as the 10 Year Plan is being implemented. While NHS England and the Department for Health and Social Care have outlined...
Matched on
terms: care, health, integration, poor
Committee recommendation
99match
#34 - Second Report - Long-term funding of adult social care
Integration strategies should seek to integrate not just health and care but health, care and housing. Ensuring there is holistic care that fits around a person’s needs includes preventing care needs from arising by having suitable housing, enabling people to live independently in their own homes, and ensuring that people receive the right care and support in the...
Matched on
terms: care, health, integration, social
Committee recommendation
98match
#4 - Thirty-Fifth Report - Introducing Integrated Care Systems
These reforms do nothing to address the longstanding tension caused by differences in funding and accountability arrangements between the NHS and social care. The Department, which has policy responsibility for both health and social care, is showing a worrying lack of leadership, and it is not clear who will intervene if relationships between local partners break down. The...
Matched on
terms: care, health, social
NAO recommendation
98match
Introducing Integrated Care Systems: joining up local services to improve health outcomes
a) DHSC and the Department for Levelling Up, Housing & Communities should, by April 2023, establish transparent arrangements across government and with wider stakeholders to tackle the drivers of poor health outcomes, including education, employment, benefits, and transport;
Matched on
terms: care, health, poor
Committee recommendation
95match
#33 - Second Report - Long-term funding of adult social care
We welcome the Joining up Care for People, Places and Populations White Paper and commend the Government for making the integration of health and social care a policy priority. We particularly welcome the Government’s ambitions around shared outcomes, workforce integration, and ensuring every citizen has a shared care record by 2024. However, we are concerned that inconsistent geographical...
Matched on
terms: care, health, integration, social
Committee recommendation
95match
#13 - DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.
DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would be hard to do and should take place only over the long term and not at the expense...
Matched on
terms: care, health
Committee recommendation
95match
#83 - Publish joint statutory guidance on safe delegation of healthcare responsibilities in schools and trusts.
The Department for Education and the Department of Health and Social Care should issue joint statutory guidance clarifying how and when healthcare responsibilities can safely be delegated in schools and multi- academy trusts. This should be produced in collaboration with school and multi-academy trust leaders and health and education unions and set out clear lines of accountability between...
Matched on
terms: care, health, social
PHSO recommendation
94match
Discharge from mental health care: making it safe and patient-centred
We note the Department of Health and Social Care's (DHSC) national statutory guidance on discharge from mental health settings. As it is implemented, DHSC and NHS England must engage with people and services to assess the impact the guidance has on them. In particular, they must make sure that Integrated Care Systems account for the different professionals that...
Matched on
terms: care, health, social
Committee recommendation
90match
#84 - Appoint a dedicated national SEND lead within DHSC to drive health system accountability.
The Department of Health and Social Care must urgently appoint a dedicated national SEND lead to drive accountability and coordination across the health system. This role must be empowered and mandated to provide coherent strategic leadership on the delivery of health- related SEND duties, forge robust partnerships with education and 173 care sectors, and ensure that the needs...
Matched on
terms: care, health, social
Committee recommendation
90match
#33 - Improve cross-departmental coordination and strengthen accountability for SEND health services at ICB level.
The Department for Education must significantly improve cross- departmental coordination with the Department of Health and Social Care and NHS England to establish clear, consistent accountability for SEND at the ICB level. Current arrangements are fragmented and lack clarity. Strengthening the role, authority, and visibility of the Senior Responsible Officer for SEND within ICBs is essential to ensure...
Matched on
terms: care, health, social
Committee recommendation
90match
#26 - NHSE abolition announced alongside significant cost-cutting demands on Integrated Care Boards
On 13 March 2025, the Government announced that NHSE would be abolished within two years and that the Department would put in place arrangements to deliver the responsibilities currently delivered by NHSE.57 On the same day, as part of our evidence session on the 2023–24 Annual Report and Accounts of the Department for Health and Social Care, we...
Matched on
terms: care, health, social
LGO / SPSO decision
90match
18-006-752d - NHS West Yorkshire Health and Care Partnership Integrated Care Board (18 006 752d)
Summary: We found fault by the Council, Trust and ICB in terms of the care and support they provided to a man with complex needs. We recommend these organisations carry out a thorough reassessment of his needs and put in place a comprehensive care plan that sets out how they will meet these needs.
Matched on
terms: care, health, social
LGO / SPSO decision
90match
18-006-752c - NHS West Yorkshire Health and Care Partnership Integrated Care Board (18 006 752c)
Summary: We found fault by the Council, Trust and ICB in terms of the care and support they provided to a man with complex needs. We recommend these organisations carry out a thorough reassessment of his needs and put in place a comprehensive care plan that sets out how they will meet these needs.
Matched on
terms: care, health, social
PFD report
85match
Margaret Conway
Systemic separation of mental and physical health services led to challenging patient transfers and fragmented care for individuals with co-occurring serious mental and physical health problems. Closer integration and shared resources are needed.
Matched on
terms: care, health, integration
Committee recommendation
85match
#24 - Overall NHS productivity remains low despite increased elective activity and community investments.
Despite carrying out 15% more elective activity than before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered.42 NHSE told us that, while government has had a long-term aim to shift more care and services into local communities, funding increases for these services had often been...
Matched on
terms: care, health, social
Committee recommendation
85match
#6 - Ensure greater NHSE funding for community services, preventing redirection to hospitals.
NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected funding to prop up the day-to-day spending of local NHS systems. Despite carrying out 15% more elective activity...
Matched on
terms: care, health, social
Committee recommendation
82match
#41 - Women's health hub model shows promise but faces systemic challenges and risks unequal access.
The expansion of the women’s health hub model has the potential to be a positive step towards providing the joined-up care and commissioning needed to effectively support women experiencing reproductive health conditions. However, the women’s health hub model exists within a healthcare system which has significant commissioning, funding, workforce and expertise problems, particularly in the area of reproductive...
Matched on
terms: care, health
PFD report
81match
Mary James
Inadequate INR monitoring, uncertainty regarding Warfarin intake, and poor communication between healthcare providers led to unadjusted anticoagulation therapy for a dementia patient, missing a critical hospital admission opportunity.
Matched on
terms: care, health, poor
PFD report
81match
Barbara Ellis
A patient with cross-border care arrangements was unable to access therapeutic services because her healthcare was commissioned by one county and social care by another.
Matched on
terms: care, health, social
LGO / SPSO decision
81match
201809536 - Argyll and Bute Health and Social Care Partnership
Mr and Mrs C complained about the partnership's management of their adult son's care (Mr A). Mr A's care was managed by the partnership for a number of years. The partnership moved Mr A's care away from his family base when they came to the view that the level of support he required could not be provided at...
Matched on
terms: care, health, social
Committee recommendation
81match
#48 - Third Report - Coronavirus: lessons learned to date
Planning for future pandemics should have a more developed and explicit consideration of the intense interaction between the NHS and social care. The prominence of social care within the Department of Health and Social Care should be enhanced and Ministers must address the relative lack of knowledge and experience of social care within the Department and senior levels...
Matched on
terms: care, health, social
Committee recommendation
81match
#48 - Sixth Report - Coronavirus: lessons learned to date
Planning for future pandemics should have a more developed and explicit consideration of the intense interaction between the NHS and social care. The prominence of social care within the Department of Health and Social Care should be enhanced and Ministers must address the relative lack of knowledge and experience of social care within the Department and senior levels...
Matched on
terms: care, health, social
Inquiry recommendation
81match
BRIS-177 - NSF must provide strategic guidance for integrating children's healthcare services
There must be much greater integration of primary, community, acute and specialist healthcare for children. The NSF should include strategic guidance to health authorities and trusts so that services in the future are better integrated and organised around the needs of children and their families.
Matched on
terms: care, health, integration
Committee recommendation
78match
#2 - Inconsistent FGM survivor services and poor referral pathways create postcode lottery
Services for FGM survivors and access to them remains inconsistent across the UK. While some variation in access to services may be expected in line with local prevalence, there is a lack of effective referral pathways. This has created a postcode lottery that risks leaving women and girls without the essential support and care they need. (Conclusion, Paragraph...
Matched on
terms: care, poor
NAO recommendation
78match
Reforming adult social care in England
As it turns its attention to charging reform alongside system reform, DHSC should publish a long-term plan mapping its reform activity and the funding it will need to achieve its planned outcomes
Matched on
terms: care, social
PFD report
77match
Colin Williams
A client with complex health and social needs, exacerbated by alcoholism, experienced "agency blindness" and lacked consistent support due to fragmented services, funding changes, and administrative difficulties.
Matched on
terms: health, social
PFD report
77match
Jonathan Zucker
A lack of a lead clinician or systemic coordination between private and NHS mental health services resulted in fragmented patient care oversight.
Matched on
terms: care, health
PFD report
77match
Lee Swain
A lack of coordinated procedures for transferring mental health patients between NHS Trusts, exacerbated by exiting a Care Programme Approach, resulted in delayed intervention and ineffective information exchange.
Matched on
terms: care, health
PPO recommendation
77match
The Head of Healthcare (HMP Stafford)
The Head of Healthcare should review and improve communication methods for liaising with hospital consultants and clinics, and evidence changes in system management to NHS England commissioners.
Matched on
terms: care, health
Committee recommendation
77match
#27 - Ninth report - Clearing the backlog caused by the pandemic
In light of the Government’s commitment to reform social care, we again recommend that it publishes a ten-year plan for social care, setting out how it in detail how it will tackle the structural and financial problems the sector faces in the short-term, and operationalise its longer-term ambitions. The Government must also acknowledge the needs and wellbeing of...
Matched on
terms: care, health, social
Committee recommendation
77match
#67 - Develop joint SEND workforce plan to address shortages and re-deploy professionals therapeutically
The DfE and DHSC should urgently develop a joint SEND workforce plan to address shortages and build capacity across education, health, and care services. This should include explicit measures to deliver a shift in the deployment of educational psychologists, speech and language therapists and other allied health professionals away from undertaking assessments and writing reports and towards greater...
Matched on
terms: care, health
IMB recommendation
77match
Bronzefield (2024)
How does NHS England plan to improve the integration of the healthcare services in Bronzefield? (6.1)
Matched on
terms: care, health, integration
LGO / SPSO decision
76match
21-013-224a - Lincolnshire Community Health Services (21 013 224a)
Summary: Mrs B complained about the health and social care support provided by the Council and the NHS Trust after she removed her late husband, Mr B, from a respite placement and took him home. She also complained about the way the former Clinical Commissioning Group (CCG and now Integrated Care Board) considered whether
Matched on
terms: care, health, social
LGO / SPSO decision
76match
22-009-742 - West Northamptonshire Council
Summary: Miss D complained about the lack of mental health and social care provided to her son, Mr B, when he was discharged from hospital. She said this led to a lack of joint working between the Council, the Trust and the Integrated Care Board (ICB). She said they did not make reasonable adjustments when communicating with Mr...
Matched on
terms: care, health, social
PPO recommendation
74match
The Head of Healthcare
The Head of Healthcare should ensure that there is a local process to maintain oversight of regional bed referrals and any required escalation.
Matched on
terms: care, health
NAO recommendation
74match
The adult social care market in England
The Department should: a) as a priority, set out a cross-government, long-term, funded vision for care. It should collaborate with the Ministry and local government in particular; factoring in sector and user perspectives, such as people with lived experience;
Matched on
terms: care, social
PFD report
73match
Barry Thraves
Significant delays in psychiatric follow-up, lack of community support, and poor communication between mental health teams and GPs led to unaddressed patient deterioration.
Matched on
terms: health, poor
PFD report
73match
Charlotte Bevan and Zaani Malbrouck
There was no mandatory multi-disciplinary team meeting or widely circulated care plan for pregnant women with known mental health conditions, risking fragmented and uncoordinated care.
Matched on
terms: care, health
PFD report
73match
Philip Denning
Fragmented services for patients with co-occurring substance misuse and mental health issues, a lack of information sharing, and primary care's misunderstanding of available help pose significant risks.
Matched on
terms: care, health
Committee recommendation
73match
#12 - Second Report - Disability employment gap
Locally-commissioned employment support will require close working between local government and a variety of partners, including the NHS. Integrated care systems (ICSs) have an important role to play in strengthening these partnerships. The Government’s ambition is for every area in England to be covered by an ICS. ICSs already bring together providers and commissioners of NHS services with...
Matched on
terms: care, health
Committee recommendation
73match
#78 - SEND not a shared priority across government departments, burdening the education system.
The current failure to embed Special Educational Needs and Disabilities (SEND) as a shared priority across government departments is not just a policy oversight, it is a profound injustice to some of the most vulnerable children in our society. It is evident that SEND is not sufficiently seen as a priority by the health system. The education system...
Matched on
terms: care, health
Committee recommendation
73match
#15 - Strengthen local authorities' ability to deliver EHC plans by compelling other services
Where EHC plans are issued, they carry a statutory duty which must be delivered in full. To make this a reality, the Department for Education should strengthen the ability of local authorities to meet these obligations by ensuring that the necessary levers are in place to compel other services, for example, NHS services, and commissioners such as local...
Matched on
terms: care, health
IMB recommendation
72match
Bronzefield (2025)
What further steps will the Minister take to address the integration of the healthcare services (under NHS England commissioning) within Bronzefield, notwithstanding the Memorandum of Understanding referred to in the Minister’s letter of response to the Board’s 2023-2024 annual report (on 17 January 2025) (6.1)?
Matched on
terms: care, health, integration
Detention investigation recommendation
72match
Assessment of government progress in implementing the report on the welfare in detention of vulnerable persons - Rec...
The Home Offce and Department of Health and Social Care should prepare a joint communication to IRC healthcare teams clearly laying out health-based entitlements for former detainees released into the community.
Matched on
terms: care, health, social
Inquiry recommendation
72match
F235 - Joint proceedings
The Professional Standards Authority for Health and Social Care (PSA) (formerly the Council for Healthcare Regulatory Excellence), together with the regulators under its supervision, should seek to devise procedures for dealing consistently and in the public interest with cases arising out of the same event or series of events but involving professionals regulated by more than one body....
Matched on
terms: care, health, social
NAO recommendation
72match
The supply of personal protective equipment (PPE) during the COVID-19 pandemic
Despite efforts to integrate them over the years, health and social care have continued to be separate systems. During this crisis the social care sector was hit hard by shortages of PPE, and government needs to understand why national bodies provided more support to hospitals than to social care and how to prevent that happening again.
Matched on
terms: care, health, social
LGO / SPSO decision
72match
23-008-538 - Oxfordshire County Council
Summary: Ms X complained about Oxfordshire County Council, Oxford Health NHS Foundation Trust, and NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board. She complained about faults relating to aftercare under section 117 of the Mental Health Act 1983. We have upheld Ms X’s complaints about discharge, assessment, care planning and personal health budgets. We did not uphold...
Matched on
terms: care, health, social
IOPC learning recommendation
71match
Recommendations - Metropolitan Police Service, March 2021
The IOPC recommends that the Metropolitan Police Service (MPS) create a Memorandum of Understanding (MOU) between all London-based Mental Health Trusts and the PAN London Mental Health Group. It is recommended that this MOU includes the following points: joint mental health training; establishing a mental health team with a liaison officer and regular liaison meetings and establishing a...
Matched on
terms: care, health, social