Social services directors have criticised the Department of Health for shutting them out of plans to restructure the NHS despite their significant implications for councils, writes Mithran Samuel.
Association of Directors of Social Services leaders said they were given no prior briefings on proposals, published in late July, to slash the number of primary care trusts, affecting their relationships with councils.
President Tony Hunter said: “We have forums in place where these sorts of issues can be discussed because sometimes they have unintended consequences as is the case with this initiative.”
He cited the likelihood that smaller PCTs would be merged, despite the fact that many share the same boundaries as, and have strong links with, councils.
Hunter added: “They may have joint posts and pooled budgets in place, which would need unravelling [as a result].”
The problem stems from the tensions between two objectives in the DH’s Commissioning a patient-led NHS plan: making 15 per cent savings from restructuring trusts, and improving co-ordination between social services and PCTs by aligning boundaries.
While mergers in the shires, where there are typically many PCTs to each county council, could lead to alignment, this is not the case elsewhere, where smaller trusts and councils already cohere.
Jeff Jerome, chair of the ADSS disabilities committee, said: “It would have been good to have some kind of discussion beforehand to put a local government perspective on it because I don’t think it’s there in the proposals.”
He also attacked the rapid timetable for reform. Strategic health authorities, which manage the performance of PCTs, have been given until 15 October to put forward proposals for restructuring trusts.
A DH spokesperson said Commissioning a patient-led NHS contained nothing new in policy terms. All if it drew on last June’s NHS Improvement Plan and its successor, Creating a patient-led NHS, published in March, both of which had been consulted on, she added.
However, Hunter said: “There are real implementation issues which we feel haven’t received the full intention that they need.”
He hoped the matter would be discussed at next month’s
meeting of the social care forum, the DH’s new outlet for
consulting the sector.
