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Integrated Care Systems are not doing enough to put the vulnerable people they support at the heart of what they do, according to a new report issued jointly by the Local Government and Social Care Ombudsman and the Parliamentary and Health Service Ombudsman.

Integrated Care Systems (ICS) are organisations made up of representatives from local authority social services and NHS partnerships that work together to support the needs of people in their areas.

However, complaints investigated jointly by both Ombudsman schemes suggest people are being let down by poor communication between services.

The new report details some of the things that can and do go wrong when people are not prioritised and local organisations do not work together effectively. Cases include a boy with medical and Special Educational Needs who lost six years of education while his parents struggled to look after him because support could not be agreed. In another case a family caring for a loved one with progressing dementia were not provided with the proper practical support and advice in the final months of her life.

And in another case, a young child with complex medical and care needs spent years without the appropriate overnight care he needed while his local council and medical services argued about who should fund the support.

The report includes a recommendation for ICSs to agree a ‘person first approach’ where councils and health services work together to look at how needs can be met as their first priority. It also suggests that councils and health services agree standard frameworks for effective communication, focused on ensuring professionals on the frontline interact effectively and record all discussions and decisions.

Ms Amerdeep Somal, Local Government and Social Care Ombudsman, said:

“Local authorities and the NHS need to work as equal partners to put people at the heart of their services on every occasion. However, we are finding cases where disagreements about responsibility and funding are having a significant impact on people’s quality of life.

“When working well, Integrated Care Systems should create real improvements to services, but we are finding children and adults’ health and education compromised because the organisations meant to serve them don’t collaborate effectively.

“Our report provides an opportunity for ICSs to learn from the case studies it contains, and consider the recommendations we set out to improve the way they work together.”

Rebecca Hilsenrath, Parliamentary and Health Service Ombudsman, said:

“Individuals and families who draw on health and care services are not aware of organisational boundaries and should not need to be. The NHS and local authorities should already be working together to provide the best possible care for those who need it. But we know that is not always the case and people in vulnerable circumstances are suffering the consequences.

"ICS leaders must implement change and learn from past failings. The recommendations in this report will help leaders scrutinise local practice and ensure the needs of local people are put at the centre of services.”

The report has been produced using insight from the LGSCO/ PHSO Joint Working Team, which carries out single investigations on complaints covering issues that span both Ombudsman scheme jurisdictions of health and social care services.

You can download the report at https://www.lgo.org.uk/information-centre/reports/focus-reports

Downloads

Focus report – People not structures (2.9MB)