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The development of integrated and personalised care is a key aim of the Department of Health (DoH) following the emphasis placed on these issues in Lord Darzi’s NHS Next Stage Review published in July 2008. Since then, the DoH has introduced pilot programmes for integrated care models and personalised budgets:

• The integrated care programme has selected 16 pilots to test and evaluate innovative models of integrated care over a two year period. In this context, integration refers to partnerships, systems and models of care delivery across primary, secondary, community and social care services involving public sector bodies, third sector organisations, including social enterprises, and the private sector.
• Personalised Health Care planning within the NHS takes its lead from the social care model and supports World Class Commissioning objectives. As part of this, the DoH has launched a pilot programme to explore the potential of personal health budgets to improve the quality of patient experience and effectiveness of care.

Both programmes were intended to transform the way people experience health and social care so as to ensure that they get the right treatment and care they need for their health and well-being concerns. The programmes are being developed as part of the wider Transforming Community Services programme. 

We have advised clients on the development of a range of different integrated care models. We advise on both organisational and service delivery models using the existing powers of commissioners and other stakeholders in the system: Practice Based Commissioning consortia, soon to become GP Commissioning Consortia, local authorities and community services teams.

This includes advising on the flexible powers of Section 75 of the NHS Act 2006 which NHS bodies can use to ensure effective joint commissioning and integrated provision of health and social care services with local authorities.

It also includes advising on grant funding arrangements under Section 256 of the NHS Act 2006 and under Section 64 of the Health Services and Public Health Act 1968.

The development of Children’s Trusts is one example of integrated care. We have advised clients on issues relating to the most effective configuration of these Trusts, including wider integrated care models.

We are working with Commissioners to develop new models of personalised care planning including Independent User Trusts (IUTs). We have advised on the governance and statutory power of IUTs, top-up and direct payments in view of the Court decisions of Gunter and Harrison and Garnham. 

Our experience of advising on a range of continuing health care issues and expertise in relation to mental health care management and capacity issues informs our advice.

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