What the Health and Care Act means for social work and social care

The Government says that the Health and Care Act, which received Royal Assent at the end of April, will address the impact of the COVID-19 pandemic on the NHS, and improve the way health and social care services work, especially in relation to reducing health inequalities, and improving the care of elderly people, mental health services, and in safeguarding children.

A key aim is for better coordination between local authorities and the NHS. Announcing the new act, health and social care secretary Sajid Javid said: “The Health and Care Act is the most significant change to the healthcare system in a decade and will put it in the strongest possible position to rebuild from the pandemic, backed by our record funding.”

“These measures have broad support and will harness the best ways of working to ensure people are receiving high quality, joined-up care.”

Every part of England will be covered by an integrated care system (ICS) bringing together NHS, local government and wider system partners, with the intention of putting collaboration and partnership at the heart of healthcare planning.

From July 1, Clinical Commissioning Groups will be replaced by 42 Integrated Care Boards. The new boards will have a key role in children’s services, including setting out set five-year plans detailing how they will meet the needs of children and young adults up to the age of 25. This will be done in consultation with local leaders, and should also involve children and families.

The boards will make annual reports on their progress in safeguarding children, which the National Children’s Bureau welcomed as “one of the single most important responsibilities that [ICBs] hold…it will have to be delegated to an executive lead, as ICBs will be lead partners in local child safeguarding arrangements, together with the police and local authorities.”

“Taken together, we believe these steps will put the needs of babies, children and young people at the heart of integrated health and care services.”

The changes will be supported with additional funding, raised through the new Health and Care Levy. This will bring in an estimated £36 billion over the next three years, by temporarily increasing National Insurance contributions.

The Government aims for the new legislation were already set out in two key documents: the Long Term Plan, compiled by NHS England, which looked in detail at the impact of the pandemic on the NHS, and the Health and Social Care Integration White Paper, published in February this year.

The white paper said that integration will require changes to strengthen workforce planning in both health and social care, at national and local levels. It specifically commits the government to investment in social worker training routes.

More broadly the new legislation will mean a review of the regulation and legal requirements, to enable more flexibility in deploying health and social care staff across sectors.

A national framework for delegating healthcare will be developed. This will mean that social care workers can safely carry out a wider range of clinical interventions than at present.

Cross-sector training, and joint roles for adult social care and health staff will also be improved and the act could lead to the introduction of an Integrated Skills Passport, so that health and care staff can transfer skills and knowledge between the NHS, public health and social care.

The new law also aims to promote the importance of the roles of link workers, care navigators and care coordinators to ensure consistent access to these roles across the country

The new approach highlights the need to ensure the health and social care workforce has the right skills and knowledge to provide informed care to autistic people and people with a learning disability by making specialised [Oliver McGowan] training a legal requirement.

Other key aims of the legislation include:
- [to] support victims of abuse and respond to recent child safeguarding tragedies by committing to looking at information sharing in relation to the safeguarding of children, and requiring Integrated Care Boards to set out any proposed steps to address the particular needs of victims of abuse
- safeguarding women and girls by banning the harmful practices of virginity testing and hymenoplasty
- [to] introduce regulation of non-surgical cosmetic procedures and improve the way we regulate medical professions
- [to] address the barriers to joined-up working, by supporting data sharing between health and social care and removing barriers in the hospital discharge process, reducing unnecessary delays for patients.