Government adviser urges more government support for social worker-led services

Julian Le Grand calls for more staff-led mutuals in adult services as government review recommends their use in integrated health and social care

"Liberating" outsourcing Picture credit: Oliver Rudkin/UCF/Rex Features

The architect of social work practices has called on the government to do more to support the development of staff-run mutuals in adult social care.

The comments by London School of Economics social policy professor Julian Le Grand follow the publication of a government-commissioned review that backs the wider use of mutuals to provide NHS and integrated care services.

The review found “compelling evidence” that mutuals, which delegate services to staff, private trust companies and not-for-profit organisations, deliver higher quality care.

It said that mutuals could work particularly well in integrated health and social care, citing the impact of care providers Care Plus in North East Lincolnshire and SEQOL in Swindon as examples.

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Chris Ham, the author of the report and former strategy director for the Department of Health, said: “The evidence that more engaged staff deliver higher quality care is compelling – a simple truth that should be acted on by all NHS organisations.”

But Le Grand said that the government could have done more to support the use of mutuals in adult social care and integrated care, despite the mixed results of the social care practices pilots where independent organisations run by social workers provide statutory services for local councils.
“Mutuals liberate and engage staff- they are motivated and their capacity for innovation is increased. They have better outcomes for service users and for staff, who feel more in control of their lives,” he said.

“The burden of proof should be on the people who say it won’t work because it works in every other sector. I think with more support there’s a great deal of potential in mutuals.”

However Unison warned that the use of mutuals in health and social care was privatisation by the back door.

Christina McAnea, the union’s head of health, said: “There is a very real danger that bringing the mutual model into hospitals will be a Trojan horse for privatisation. Even in the early stages mutuals frequently mask top-level buy-outs without any real input or buy-in from staff.”

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