Plans to integrate health and social care personal budgets are less likely to succeed where local authorities have withdrawn their social workers from NHS mental health teams, according to guidance issued this week.
The guidance on integrating personal budgets in mental health says integrated assessments across health and social care are essential but more difficult where social workers have been pulled out of integrated teams. The guide is published by the Social Care Institute for Excellence (Scie) and is based on a review of research, examples of emerging practice and site visits.
The integration of social workers in mental health services run by NHS trusts has been an issue of debate in the sector in recent years. In 2012, a survey by the British Association of Social Workers found that two-fifths of local authorities had considered pulling their social workers out of integrated arrangements. Where social workers have been withdrawn by councils, it is usually due to concerns that social care outcomes have not been given enough priority by the NHS-led services.
The Scie guide is backed by NHS England chief executive Simon Stevens. In July, Stevens unveiled a new pilot scheme giving people with complex care needs the chance to control a merged NHS and social care personal budget. The Integrated Personal Commissioning programme will be piloted in 2015-16. People with severe mental health problems are one of four groups involved in the pilots.
The Scie guidance makes seven recommendations. These include that staff should support people in positive-risk tasking and health and social care organisations should cut bureaucracy and cede some control over personal budgets to service users.
“Complicated resource allocation systems, assessment processes and excessive monitoring merely reinforce a feeling that people with mental health problems are not trusted to have their own budgets,” the guide said.