Social services `little or no influence` on primary care groups and trusts

    Four out of 10 social services representatives on the boards of
    primary care groups and trusts have “little or no influence”,
    according to research carried out for the department of health,
    writes Jonathan Pearce.

    Despite encouragement from the government for PCGs and PCTs to
    work in partnership with hospitals, local authorities and the
    voluntary and private sectors in developing and commissioning
    services, progress so far is “disappointing”.

    According to a joint report by the National Primary Care
    Research and Development Centre and health think-tank The
    King’s Fund failings were most notable in the fields of
    learning disabilities, mental health and older people’s
    services, where health authorities still played a major role with
    social services departments.

    “The evidence of actual progress in current joint commissioning
    activities with social services, even in respect of priority groups
    such as older people, was disappointing,” said the survey.

    Social services representatives cited various obstacles to
    effective partnership, including PCG/T preoccupations with clinical
    matters, the dominance of a medical culture and service models,
    lack of time and the pace of change, and differences in funding and
    budget streams.

    “This is not to suggest they’re not doing anything,” said
    report co-author and the national centre’s project director
    Professor David Wilkin. “You’ve got organisations struggling
    with limited capacity to meet a wide-ranging agenda.”

    The report confirms the impression of GP-dominated
    organisations. PCGs were created in 1999 to promote greater
    collaboration between health and social care providers, in a move
    to improve efficiency and achieve more seamless care, especially
    for vulnerable groups. They were expected to evolve over time, with
    all PCGs to become PCTs by April 2004.

    However, the survey finds that when asked about the reasons for
    seeking PCT status, only one-fifth of PCGs placed integration of
    health and social services among their top three reasons.

    With last year’s NHS Plan also envisaging that PCTs could
    become care trusts – with a remit to commission and be
    responsible for all local health and social care – the report
    casts doubts on successful partnership working between health and
    social care.

    Although a small number of PCG/Ts in the survey had expressed
    interest in seeking “early care trust status”, there was “no
    evidence” that their partnership work was any more advanced than
    other PCG/Ts, according to the report: “There is a long way to go
    to realise the ambitions for a fully integrated service as
    envisioned in the NHS Plan.”

    “Some people are talking of care trusts as a way of vaulting
    PCTs’ obstacles,” said report co-author and King’s Fund
    director of primary care Dr Steve Gillam. “But they’ve got to
    have a clear understanding of what they want to do it for.”

    • Npcrdc/King’s Fund, The National Tracker Survey of
      Primary Care Groups and Trusts 2000/2001: Modernising the
      NHS?
      ; available from 0161 275 7126 or click
      here

     

     

     

     

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