Mind the capacity gap

Primary care trusts have problems. That much is clear from this
week’s National Tracker Survey.

Their problems sound all too familiar. National targets threaten
to overwhelm local priorities. The demands of change management
divert attention and resources from their core functions. And they
are simply underfunded. There is an alarming gap between
expectations and capacity.

The government made the creation of PCTs compulsory, the
pressure mounted, and frontline services may suffer as a result.
Let that be a stark lesson as the government considers – as it will
– whether to pile on the pressure to form care trusts.

For social services, as we know all too well, are struggling
with the same problems as PCTs. Ironically, social services
managers are sometimes heard to yearn for some imaginary haven of
plenty within the NHS.

Imaginary indeed. It’s a cause for serious concern when the much
vaunted “stronger partner” in an enterprise is actually struggling.
And it’s even more worrying that primary care trusts and groups
don’t see social care as a priority, and are allowing social
services representatives only limited influence.

There are two main fears. First, that structural change will
continue apace regardless, at the government’s behest, without the
cultural change required if social care is to be more than an
afterthought in some areas.

And second, it is by now a proven fact that two sides who are
both short of money will never reach an agreement that benefits
service users.