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A clinical director agreed but said it would be a huge undertaking, and there
are suspicions in the health world that local councillors will distort priorities
for the NHS, and that devolving this service to a local authority had resulted in
it being outsourced because of local government competitive tendering rules.
Few doubted that genuine health and social care integration is worth aiming
for. But delivering it is a big ask.
There will be unintended consequences and continued questions about
whether this is the beginning of a fragmentation of the NHS in England.
Dr Wilkins concluded: “We are past the point, in local government, where we
can make the necessary savings through efficiencies. It is about difficult
decisions.”
KNOWLEDGE EXCHANGE REPORTS FROM THE SHOW
INTEGRATING MENTAL AND PHYSICAL HEALTH:
ENDING THE NATIONAL SCANDAL
At least half of all people with
long-term conditions suffer from
multiple co-existing conditions.
Mental health problems are one
of the most common forms of
co-morbidity, particularly among
people from the most deprived
population groups (Barnett et al
2012).
M
ental health problems interact
with physical health and can
trigger or severely exacerbate
other conditions. For example,
depression has been associated with
a four-fold increase in the risk of heart
disease (Osborn et al 2007) and a
three-and-a-half-fold increase in
mortality rates after heart attack
(Lesperance et al 2002).
Unidentified mental health problems
often underlie 'medically unexplained
symptoms', which cost the NHS
around £3 billion each year and cause
significant distress to patients
(Bermingham et al 2010).
Between 12 and 18 per cent of all NHS
expenditure on long-term conditions is
estimated to be linked to mental health
problems (Naylor et al 2012). Across a
range of conditions, each patient with
co-morbid depression costs health
services between 30 and 140 per cent
more than equivalent patients without
depression (Welchet al