Health and local government must work better together to address the financial squeeze

02/07/2010

Health and social care services are well placed to meet the financial challenges of the future, but only if they work together more effectively than in the past, Welsh Health Minister, Edwina Hart, said in a keynote speech today.

Speaking at the second Public Services Summit, Mrs Hart said that between £1.1 billion and £1.9 billion may have to be saved by the health service over the next five years because of the financial squeeze.

But she said that over the last four years NHS Wales has already saved around £850 million and the foundations were in place to deliver both greater savings and raise the quality of patient care at the same time. 

Mrs Hart said:

"Last year alone NHS Wales achieved savings of over £200 million, through measures such as reducing the length of time patients stay in hospital and reducing unnecessary admissions.

"This year we have an unprecedented target of savings £435 million – about eight per cent of the NHS budget. That means we must move further and faster to deliver the extra savings required."

Mrs Hart said that the new NHS structure, with single health organisations delivering the full range of health services, meant the building blocks were in place for delivering more savings.

But she also said that the challenge of caring for a rapidly increasing elderly population in particular meant better joint working between the NHS and local government was crucial.

Mrs Hart said:

"The ageing population presents a range of challenges to which the health care system must respond. By 2031 people aged between 60 and 75 will have increased by a quarter and those over 75 will have increased by 75 per cent.  

"The next fundamental stage is therefore a rebalancing of care so that more services are delivered in the community closer to people's homes.

"We absolutely want to avoid people getting stuck in beds when they should never have been admitted in the first place, and we don't want to see people discharged without proper recovery and then becoming significantly greater social care costs than they might otherwise have been.

"We therefore need to keep delayed transfers and continuing healthcare in our sights as measures of our effectiveness in serving the citizen first.  

"Delayed transfers are terribly costly in simple human terms, but also in the pure financial sense. We estimate that delays are costing NHS Wales an average cost of £30 million a year – that's £30 million of avoidable cost if we can improve connections between primary, community and secondary care.

"Savings of this size cannot be sustained without creating integrated services and strong partnerships – this can only be done if the NHS and local government in Wales work together to share the challenges and solutions.

"We must avoid the sort of cost shunting that might happen at the complex interfaces of our services."

Mrs Hart pointed to examples of where joined-up services have already started to deliver, such as the integration of health and social care services in Carmarthenshire following the local authority and health board's work on community services, where a single point of access for citizens, fully integrated assessments and integrated frontline teams are in place.