Audit Commission reports on improving value for money across health and social care

For all the focus on joint working across the NHS and social care in recent years progress has been patchy. The Audit Commission has identified that PCTs could improve outcomes and achieve £132 million in efficiency savings per year.  This readable briefing for health and social care commissioners focuses on services for older people with one or more long-term condition. It sets out potential areas for local action, questions commissioners could be asking plus evidence that may help with the answers.

The Audit Commission document suggests interventions that might help, and shares two case studies: Joint Commissioning in Essex and NHS and social care integration in North West England. These areas have embraced partnership working, adopted best practice and used local data and benchmarking to establish how and where to place investment to make improvements.  

The efficiency challenge provides an incentive to build a whole-system approach to value for money. On the other hand there is a risk that organisations could retreat from joint working.  This could lead to  ‘cost-shunting’ and greater costs in the future as well as worse outcomes for people.

The report recommends using existing data for five indicators of integrated care for people aged 65 and over. These span emergency admissions, emergency bed days, admissions to residential and nursing care, and the numbers of people dying at home.  A benchmarking tool (Excel, 1.1MB) accompanies the briefing.


Joining up health and social care: Improving value for money across the interface (PDF, 4MB), Audit Commission, Dec 2011.

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