Integrated care in a cold climate

Following a global recession, public services in many countries are preparing themselves for the worst in terms of future public spending. In the UK (which seems worse hit than many), the potential cuts are substantial. After year-on-year funding increases to bring England closer to European levels of health care spending, the National Health Service now faces the very real prospect of active cuts. With many of the main political parties pledging to protect the NHS as much as possible, other services—such as adult social care—could be hit to an even greater extent. At a time when the population in ageing and demand increasing, services could find themselves with the real prospect of having to meet ever greater need with less and less resource. According to one estimate, NHS funding could fall by around two per cent per year in real terms from 2011 to 2014—requiring the NHS to find savings of around £15–20 billion over three years [1]. This, Ham argues, could represent “the longest, sustained period of disinvestment in the history of the NHS” [1, p. 2].