Experts from the University of Birmingham are calling for a fundamental change to health and social care to ensure its survival in the current economic context. According to a major new policy paper, existing approaches to spending health and social care resources will be insufficient to respond to the current financial, demographic and social challenges we face.

All in this together? Making best use of health and social care resources in an era of austerity, written by Professor Jon Glasby, Helen Dickinson and Robin Miller from the University of Birmingham’s Health Services Management Centre seeks to contribute to an ongoing debate about how best to use health and social care resources in difficult financial circumstances.

The paper outlines the limitations of rapid structural change, which has often been seen as a ‘solution’ to health and social care resource challenges. It identifies that recent organisational restructuring within the NHS have on the whole failed to produce better results as there is insufficient time for changes to become embedded and deliver the intended impacts Instead, it is noted that repeated structural change often leads to staff becoming demoralized and cynical, as they perceive that resources are being wasted on changes that are not sufficiently thought through and based on evidence.

Four alternate approaches are proposed within the paper which will enable the best possible outcomes for health and social care resources in this difficult time of funding cuts:

 Focus should be placed on outcomes rather than targets, producing transparent data about performance and holding the entire system to account for its achievement of certain key outcomes

 Spending on adult social care should be viewed as a form of social and economic investment that can improve people’s lives and therefore generate savings in other areas of the welfare state

 Personalisation of healthcare resources to enable individuals a greater sense of choice and control over how healthcare resources are spent, enabling active citizens to co-produce their own solutions and support

 Creation of ‘NHS Local’ whereby local authorities have a strong relationship with and influence over local health services, encouraging greater local democratic accountability through integration of both health and social care commission into local government

Robin Miller, Senior Fellow at the Health Services Management Centre at the University of Birmingham explains:

“Health and social care is vital to efficiently address the increasing demands that result from people living longer. We need to have a new vision for what can be achieved and how health and social care can work together. However, the proposed changes to the health service could potentially make joint working even more tricky – many GP consortia will overlap local authority boundaries, public health staff may be largely employed by a national organisation and there is going to be more diversity in the range of providers.”

Professor Jon Glasby, Director of the Health Services Management Centre adds:

“While the emphasis on new Health and Well-being Boards is helpful, the fact remains that there will be much to strain relations. Partnership has never been easy but it may be about to get a lot more difficult.”

The paper summarises HSMC and Birmingham’s contribution to a discussion which took place at a policy dinner hosted by Vice-Chancellor Professor David Eastwood and attended by a number of leading health and social care stakeholders and commentators.

For more information, please contact Professor Jon Glasby via 0121 414 7068 or or Robin Miller via 0121 414 8018 or

Notes to Editors

About HSMC

HSMC has been one of the leading UK centres for research, personal and organisational development in healthcare for nearly 40 years. Commissioning of healthcare and provision of healthcare outside hospitals have become specific areas of expertise in recent years, underpinned by a continuing commitment to issues of quality improvement and public and patient engagement. This reputation also includes adult social care, with a growing track record in inter-agency commissioning and provision of health and social care services. HSMC has also developed a national reputation for both organisational and leadership development across all health settings.

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For media information

Ben Hill, University of Birmingham Press Office, Tel: 0121 414 5134 or