Integration of health and social care, greater emphasis on third sector service delivery and new social investment funding models. Three significant policies that are coming together to produce radical new opportunities for providers of health and social care services.

On the commissioner side, legislation has made integration of health and social care a statutory demand. The £3.8bn now available for Health and Social Well Being boards for integration projects has made the demand realistic.

The emphasis is now on ideas for innovation and routes to delivery, both areas where providers in the health and social care market can add real value and take forward ideas to commissioners.

The more radical solutions are focusing on 'integration through provider' models. This is resulting in commissioners in health and social care exploring payment by outcomes models focusing on top level outcomes with a provider responsible for integrating the activity that achieves the outcomes.

This creates a challenge for providers – who will pay for the activity pending the outcomes being met (and take the risk of not being paid if the outcomes are not met)? For many providers in the health and social care market this is not viable. A developing social investment market is growing in response to this, offering to fund third sector providers delivering under PbR contracts with the funders receiving a return upon the outcomes being met. This approach (often structured as a 'Social Impact Bond' or 'SIB') is now in use across the public sector, funding projects from homelessness to reoffending to child social care, and is growing all the time.

End of life care in the West Midlands provides a good example of the new type of opportunity. We are supporting Marie Curie Cancer Care who are proactively working with Sandwell and West Birmingham CCG on an innovative social investment pilot to explore transforming end of life care through greater integration of services resulting in reduced demand on hospital beds, click here more information.  If successful the pilot will establish proof of concept for new finance and contracting opportunity for NHS commissioners.

There is unprecedented scope for providers to help shape health and social care solutions and real opportunities to be central to the delivery of the agenda. With large scale government funding and a burgeoning social investment market the emphasis is on providers and commissioners to propose viable solutions.

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