Government plans to remove local authorities from integrated care boards (ICBs) will exacerbate the provision of vital social care within palliative care services, an influential committee of MPs has warned.
The government’s flagship 10 Year Health Plan set out plans to remove local authority representatives from ICBs and replace them with strategic authority mayors.
But in a new report the Health and Social Care Committee is now urging the government to ‘reconsider’ its decision to ‘ensure social care is represented, understood and appropriately commissioned to deliver end of life care.
The report, part of the committee’s inquiry into palliative care, said: ‘The role of social care in the provision of palliative and end of life care has been overlooked for far too long, and we are concerned that the government’s plans to remove local authorities from ICBs will only make the current situation worse, particularly in the context of the government’s aim to shift care into the community.
‘We urge the government to reconsider its decision to remove, through legislation, local authority representation on ICBs, to ensure social care is represented, understood and appropriately commissioned to deliver end of life care.’
The committee said its Independent Expert Panel’s evaluation of the palliative care sector had revealed an ‘understaffed workforce’, impacts felt from inadequate social care services, and fragmented services that were hard for patients and families to navigate.
The panel found that these factors combined with the sector being ‘overlooked by NHS commissioners and varying levels of need had led to a ‘postcode lottery in the quality of services across England.
The committee welcomed government plans to introduce a Modern Service Framework (MSF), which will set the national standards for palliative and end of life care.
It called for the framework to continue specific standards for how children’s, babies’ and young people’s palliative care should be provided, the need for 24/7 services throughout the country, and a plan to strengthen the workforce of specialist doctors, nurses and other healthcare professionals.
Committee chair Layla Moran said: ‘It is welcome that this neglected sector is finally getting renewed attention.
‘But this committee is sceptical of how much store has been set on the MSF, in particular when there has been no indication that additional resources are coming, other than one-off capital investments which will do little to tackle poor recruitment and retention.’
She added: ‘When the MSF does materialise, we will go over it with a fine-toothed comb and hold ministers and officials to account for how their plans will be put into action.’
The report also called on the government to lay out the ‘accountability arrangements’ that will be put in place to support the implementation of the MSF and the ‘concrete steps’ that the Department of Health and Social Care (DHSC) will take with ICBs which do not fulfil this.
It also said that the government must ensure that ICBs have the support, tools and resources they need to deliver on the MSF, and the MSF must include specific guidelines and requirements for ICBs to enable access to 24/7 palliative services, including access to medication, and in-person care where necessary.
A DHSC spokesperson said the MSF will be developed following engagement with the sector and will address significant challenges the sector has warned about, including avoidable hospital admissions, variation in local and regional provision of care in terms of both access and quality, workforce shortages and gaps in 24/7 palliative care provision.
They added: ‘This government has made the biggest investment in hospices in a generation – £125 million – to improve hospice facilities, freeing other funding for patient care, and has also committed £80 million for children’s and young people’s hospices over three years.
‘We will soon set out our plans to modernise and improve the palliative and end of life care sector, as we shift more healthcare out of hospitals and into the community with hospices playing a central role in delivering care closer to home.’
