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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