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The restructuring of the Department of Health is intended to ensure wider understanding of social care issues rather than allow the sector to be marginalised, NHS chief executive Nigel Crisp said last week.

Describing the change as "behavioural rather than structural", he said there would still be "someone senior" from social services in the new-look department.

Crisp was speaking at the Association of Directors of Social Services' spring seminar in Liverpool.

Under the change outlined last month the DoH will be split into three divisions, none of which will be headed by a professional with a social care background.


The Health and Social Care Standards Group will be led by chief medical officer Liam Donaldson, who will have a team of three including one responsible for social care (news, page 8, 27 March). The Social Services Inspectorate will no longer sit within the department.

Crisp said the rationale behind the change was to move understanding of social care from the hands of the few into the hands of the many. Merging the SSI with the majority of the National Care Standards Commission to form the independent Commission for Social Care Inspection would also "build confidence" in the system.

His only praise for the sector was reserved for its role in helping hospitals meet their targets on delayed discharges and A&E waiting times. Yet he denied there was too much focus on acute targets, although directors insisted the obsession was hindering joint working.


Directors rejected Crisp's suggestion that social care jobs were often filled through informal networks. They also criticised his comments about using the seminar to recruit directors to work in the NHS.

Wiltshire social services director Ray Jones said: "There is concern around the restructuring of the DoH and whether it is going to leave social care more and more marginalised."

He said Crisp's "NHS-centric" presentation suggested that this was "even more of a concern than it might have been".