Care trusts are logical step but pay may create problem

    Further integration between social services and health is key to
    improving services, according to evidence from the first integrated
    trust in Britain.

    Somerset Partnership NHS and Social Care Trust was set up in
    1999 as a single integrated mental health and social care provider,
    alongside a joint commissioning board with devolved responsibility
    for all spending on mental health.

    Despite being established before the introduction of greater
    flexibility and freedom in joint working arrangements, the outcome
    was effectively a blueprint for the care trusts outlined in the
    Health and Social Care Act 2001. Trust executive director and
    social worker Sue Okell said she was convinced that, in terms of
    service-user benefits, further integration between health and
    social services was the way forward.

    Speaking at a meeting on partnership working with the health
    sector at the Local Government Association’s annual conference last
    week, Okell said: “I worked for 25 years in the local authority
    sector and I had serious reservations about whether I could make
    that transition [to an integrated trust]. Now I’m convinced.”

    She said moving to care trust status was a logical step, and
    added that it was vital to introduce measures to ensure social care
    functions were not lost.

    She said that moving to a single integrated trust had resulted
    in definite savings, improved services for service-users, greater
    user and carer involvement in planning, less duplication and
    improved working relationships.

    However, she warned that in the integrated trust model staff
    issues could be a problem, as differences in pay and working
    conditions between team members became apparent. “People are doing
    similar jobs for different pay and conditions,” Okell said. “It is
    a source of conflict and is becoming more of an issue now [staff]
    are in the same buildings, in the same meetings. It’s a problem
    that will have to be dealt with nationally.”

    Annie Ralph, chief executive of Braintree Council, Essex, which
    has put in a joint bid with the local primary care group to become
    one of the government’s care trust demonstration sites or pilots,
    predicted that care trust status would create “opportunities to
    significantly help solve recruitment and retention problems”.

    She said that staff were committed to good quality services and
    the notion of a single care package. “One of the deciding factors
    for the level of interest [in our expression of interest] was that
    we are bringing the holistic view with housing as well.”

    The Department of Health sent out letters last month inviting
    bids for demonstration sites for care trusts by the end of July
    (News, page 3, 28 June).

    Deputy manager of the DoH’s older people taskforce, William
    Vineall, told the National Housing Federation’s housing care and
    support conference last week that between six and eight expressions
    of interest had been received so far. “We have an expectation of
    getting 12, 15 or 20 expressions of interest in the next few
    weeks,” he said.

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