Government proposals for GPs to commission social care services have been greeted with scepticism by local government leaders, who have warned that the plans lack detail and may prove unfeasible for the cash-strapped NHS.
The Commissioning Framework for Health and Well-being, released this week, is designed to promote a shift from acute to preventive services. It says GPs are well-placed to buy preventive services for patients, including social care.
Primary care trusts and GP commissioners should be more flexible in the way they use NHS funds, it says, adding that spending on respite care, housing aids and adaptations, advocacy services, parenting support and services to help older people maintain their independence were all acceptable (see Health and social care).
Such measures would fulfil long-standing calls from social care leaders for NHS money to be poured into social care.
However, Local Government Association chair Sandy Bruce-Lockhart questioned whether, given current NHS deficits, GPs would have the capacity to invest in social care without duplicating what councils commission, and also warned of a two-tier system of council and NHS-commissioned social care.
Incoming vice-president of the Association of Directors of Adult Social Services John Dixon (pictured) welcomed the call for NHS spending on social care, but added: “It’s so theoretical. We still need to have some more specific mechanisms.”
Despite last year’s health and social care white paper, which called for a year-on-year shift in NHS resources from acute services to preventive care, Dixon said the NHS was still “very much focused on hospital care”.
Michael Sobanja, chief executive of the NHS Alliance, which represents PCTs, said NHS investment in social care was likely to be patchy initially, but added: “If we are able to demonstrate the successes and returns from this activity, it will spread.”
● Commissioning Framework for Health and Well-being available at www.dh.gov.uk
Health and social care
Under the NHS Act 1977, the NHS can purchase services to prevent illness, for people suffering from illness or for their after-care, so long as the services are an appropriate part of the NHS. The government wants PCTs and GPs to interpret the legislation flexibly. One problem could be that council-commissioned social care for adults is means-tested while GP-commissioned services are free.
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