Primary care trusts were no longer “fit for purpose” and had to go as the price to deliver integrated health and social care, according to care services minister Paul Burstow.
Speaking to Community Care after the government announced the abolition of PCTs, Burstow said most had not “succeeded in delivering integration in many places” despite a few beacons around the country.
Now he said local government should be in the driving seat on integration through councils’ new strategic commissioning role as outlined in yesterday’s health White Paper, Equity and Excellence: Liberating the NHS.
This laid out a new statutory responsibility for local authorities to take on PCTs’ public health functions and to lead on integrating health and social care locally.
This will be through new health and well-being boards or within existing strategic partnerships though Burstow said government did not want to prescribe what boards should look like or who should sit on them.
Consortia of GP practices will take on responsibility for commissioning most health services from PCTs.
The paper also outlined an intention to make it easier and quicker for councils to set up partnership arrangements between health and social care, though it is currently unclear what will happen to existing arrangements between councils and PCTs.
Burstow said: “It [the boards] would be the place where there’s an alignment of the commissioning strategies that takes place.
“The commissioning function around social care would still sit within the local authority, but we would expect that smart local authorities would want to make sure that GPs have influence over their commissioning – social care and public health – and indeed they would have influence over GPs commissioning consortia.”
He said: “What [the boards do] is deepen and strengthen the relationship because the GPs in their consortia, the local authorities, social services, children’s services and public health responsibilities come together in one place to work together to deliver the better system that we want to achieve.”
The coalition’s programme for government, published in May, had put forward a role for PCTs, purchasing services not commissioned by GPs, and becoming the democratic voice of the NHS, through having some elected board members.
But Burstow added that under the White Paper proposals there was “much stronger accountability across the system locally and integration [was] being really driven in the system”.
He said: “I think we’ve cleared out of the way something [the PCTs] that has not succeeded in delivering integration in many places.
“There are a few beacons around the country that have done it but the beacons have not been bright enough to encourage everyone else to follow that lead so we are now putting in place some very clear frameworks at the local level that really create the opportunity to work together.”
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