This guidance published by the Department of Health will support health and social care providers to ensure that they comply with Monitor’s new provider licence that includes the requirement to provide integrated care.
The Health and Social Care Act 2012 focuses on the importance of integrated care and support for the NHS and its integral national and local partners. This provides a real opportunity for localities to design, commission and deliver care and support services in a more integrated way for their communities.
NHS England and Monitor have statutory duties, respectively, to promote and enable integrated care. Clinical Commissioning Groups (CCGs) and Health and Wellbeing Boards (HWBs) have statutory duties, respectively, to promote and encourage delivery of integration within their local areas.
Commissioners will be working with providers to develop and fund better and more integrated care. Monitor’s role as the sector regulator will be to work with others, particularly commissioners, to remove any barriers and consider how to enable integrated care provision where this is in the interests of patients.
The requirement to provide integrated care applies to all licence holders and prohibits licensees from doing anything that could be reasonably regarded as detrimental to enabling integrated care. It also includes a patient interest test. This means that the obligations in the condition only apply to the extent that they are in the interests of patients.
In most cases it would be expected that integrated care is delivered locally by commissioners working with providers and specifying any relevant requirements through contracts. However, if a licensed provider is acting in a way that is detrimental to enabling integrated care, Monitor will be able to take enforcement action against that provider.
Monitor has published guidance on the general approach that will be taken to enforce the provider licence (including the integrated care licence condition). The guidance explains when Monitor may formally investigate potential breaches, the processes it is likely to follow and the factors that may be considered when deciding what requirements to impose should Monitor find a breach of the provider licence.
Monitor’s research report and the resource sheet published by the Local Government Association include some case study examples of approaches to integrated care taken by localities.