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
    ; available from 0161 275 7126 or click





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