A society, indeed a Government, will be judged by how it treats its most vulnerable citizens. Thanks to advances in medicine technology, and with adequate interventions, people are living longer, and those diagnosed with chronic conditions can now expect a better quality of life. Older people are some of the heaviest users of both health and social services, bearing the brunt most when systems fail. It is really quite worrying when the older people’s commissioner, Sarah Rochira, stated recently that she is regularly asked by older people, ‘Why doesn’t anyone talk to each other?’ The prediction is that, by 2030, the number of people aged 85 and over in Wales will increase to 85,000—that is an increase of 90%. If we are to address the looming shortfall in care we as an Assembly must act now. Increasingly complex health needs necessitate a seamless, integrated service that enhances patient outcomes and further improves life expectancy

 The words ‘integrated health and social care plans’ seem to have become buzz words—actual reform is now blatantly required. Integrated services not only improve patient treatment, care and discharge outcomes, but also seek to reduce financial burdens on health and social services budgets. The UK Government has made the commitment to allocate £3.8 billion of NHS budgets in 2015-16 to services that are commissioned jointly. This acknowledges the need to shift focus onto prevention rather than cure. It has proven that timely interventions and appropriate treatment for conditions such as dementia, stroke and neurological disorders can enable many to live much longer and fuller lives.

The Nuffield Trust undertook a study of 16 older people’s partnership projects and found that integrated care services not only led to a reduction in planned admission but also in improved patient care. However, let us not delude ourselves that integrating care is easy. A major barrier stems from the disparity between the number of health boards and local authorities. With seven health boards servicing 22 local authorities there is often a disconnect between policy and targets, obstructing delivery and leading to elderly patients occupying bed spaces when they should and could be at home. In the more extreme, we see vulnerable people leaving hospital in the early hours, often left alone without any safe, structured care plan in place. There needs to be a simplification of the way that local authorities plan for and deliver care to foster better relationships with health boards. However, it is a two-way street.

As an example of best practice, we can look at the steps taken by Liverpool City Council, which has invested over £6 million to develop hubs whose purpose is to better support vulnerable adults. The investment has also introduced reablement beds that are supported by multi-disciplinary teams. They have supported some 627 episodes of care, where 56% of services users returned home with no further need of support; the others returned home with a comprehensive care package in place.

The Welsh Government should now be working with health authorities from across the United Kingdom to share best practice. This is not about boasting who has the best ideas. This is about delivering care that our most vulnerable need and certainly deserve. In its report on integrated health and social care, the King’s Fund studied the model in Northern Ireland, which has had integrated health and social services for 40 years. While it highlights successes in patient discharge and comprehensive care plans, it raises concerns that the values of social care are often overshadowed by the dominant health agenda. Welsh Government policy on integrated care must pay sufficient heed to the importance of both fields. Integration is not an end in itself. Integration must be seen as a means of providing seamless care that is fully responsive to the needs of patients in Wales. I am not alone in aspiring to a time when health and social services work together as a matter of course. Let us not wait a moment longer. Let us turn that aspiration into ambition and action.