Daily reports from the National Social Services Conference

Deputy mayor of New York speaks to conference

An interview with the deputy mayor of New York
in which he talked about the aftermath of the September 11 tragedy was relayed
to delegates at the National Social Services Conference, writes David
Callaghan.

The Local Government Association’s head of social affairs
John Ransford travelled to New York to talk to Anthony Coles about the efforts
made by the city’s leadership to return it to some normality and revive the
morale of citizens.

Coles apologised for not being able to attend the conference
in person, but explained how the terrorist attack had been the preoccupation of
everyone in New York.

He said the city had been forced to ‘peg back’ budgets by 15
per cent because a downturn in the city’s economy will reduce civic revenues by
an estimated $1 billion in this financial year. Tax rises have been ruled out,
he said, and there may even be tax cuts to stimulate the economy.

Video clips of New York’s mayor Rudolph Giuliani giving a
briefing on the financial implications of the attacks were also shown.

Ransford said: ‘The most encouraging thing we found was the
absolute absence of rancour. But there is a search for understanding for why
this happened and not a thirst for revenge.’

He said this country could learn from the Americans’
resolve, and use their experience to address problems such as inequality.

More support needed for disabled parents

Disabled parents are often unable to access
support through community care because their needs are not accounted for in
eligibility criteria, delegates heard, writes Sally Gillen.

Researcher Michele Wates, who was commissioned by the Joseph
Rowntree Foundation to examine social services’ departments written protocols
on disabled parents, said: “We very much hope that in the forthcoming fair
access to care services, the policy guidance of which is out for consultation,
social services should include something on the parenting role and tasks within
the eligibility criteria in community care services.”

Only a handful of the country’s 150-plus departments had a
set of protocols that focused particularly on disabled parents, she said.

Other findings included in her report, which will be
published early next year, were that disabled parents are anxious about
approaching social services for help, but few measures were taken to address
these fears, and in over half of the 30 policies and protocols analysed for the
research the intention to support disabled parents was not translated into
measures that would be supportive in practice.

Wates told delegates: “We hear of parents who are told (when
they approach social services) to go away and come back when there is a
problem.”

Disabled parents are often reluctant to ask social services
for help because they do not want their children labelled as being children in
need, said Wates.

Social services were often too eager to transfer the
children of disabled people to children’s services and support for the parents
often drops off the agenda.

She said: “More guidance is needed from the department of
health as to how children and adult services can best co-operate and work for
disabled parents.”

Closer working arrangements delayed six months

Progress towards closer working between health
and social services will be delayed by at least six months as a result of
internal restructuring within the NHS, local authorities warned, writes
Lauren Revans.

Delegates attending a policy session on the way forward for
health and social care heard that the changes outlined in government’s document
published this summer, Shifting the
Balance of Power in the NHS, would leave health organisations with no
choice but to focus on internal changes rather than partnership arrangements.

The document proposes replacing the 95 health authorities in
England with around 30 strategic health authorities from April 2002, and making
primary care trusts the lead NHS organisations with responsibility for
assessing need, planning and securing all health services, and improving health
in their localities.

Richard Humphries, chief executive of Herefordshire health
authority and director of health, housing and social care at Herefordshire
Council, said: “The NHS will be looking at its own internal structures instead
of outwards at the partnerships. That will set the process back. It’s going to
need six months from April to settle down.”

Dave Martin, acting chief executive of Sandwell health
authority and executive director for social exclusion and health at Sandwell
Council, urged local authorities to be patient with their health colleagues.

“It’s about having confidence,” he said. “We need to do
everything we can to keep key players doing pretty much what they were doing
before. If they turn up in a different structure it doesn’t matter – they won’t
change their spots.

Martin predicted that “re-engagement” with health partners
post restructuring would be gradual, with several phases. “Everyone has a very
complicated set of changes ahead of them, and at the same time we are trying to
turn round and modernise services,” he said.

* Youth offending teams or community mental
health groups are good templates for care trust structures, the conference was
told.

David Browning, who is associate director of public services
research for the Audit Commission, said multi-disciplinary teams such as YOTs
and mental health teams form an effective model to follow.

He also said a ‘network manager’ can help to co-ordinate the
partnership working between agencies essential if care trusts are to be
successful.

Brian Dornan, who is director of social services for
Southern Health and Social Services Board in Northern Ireland, explained how
Down and Lisburn Health Trust combined health and social services into one
organisation.

Primary care teams were created, including social services,
based in GP practices. "There is no wall between health and social care
staff," he said.

He said 90 per cent of staff preferred the new integrated
working arrangements, and believed it led to improved services.

Dornan said it was important to avoid nominal integration
and domination of one profession.

Tories promise improved professional standing
for social work

Tim Loughton, the new Conservative social
services spokesperson, provided a pastiche of recent briefings from social
services chiefs on the current crisis facing social care, writes Rachel
Downey.

“Many social services departments are no longer able
adequately to carry out their statutory responsibilities,” he told
delegates. 

He outlined staff shortages, increases in demand, an unfair
distribution of resources between the NHS and social care and initiative
overload “where central government gets all the kudos, but local government
departments will get all the flak when it all goes wrong”.

Last week’s announcement of an additional £300 million to
combat bed blocking this winter was “a drop in the ocean”, he added, warning
the government “would not be forgiven a second time” if it failed to meet its
targets on care of older people.

His solutions were limited. He suggested examining “not just
independent treatment episodes but the whole system of care holistically”, and
looking at the transfer of funds from acute hospital sector to care in the
community to give a better balance.

The only new proposal was a national independent assessment
forum, which would devise a standard for assessing care needs to cover the
whole country. 

Loughton said he hoped the forthcoming government
recruitment campaign would not just focus on raising qualifications but the
public perception of the profession. He claimed the Conservative party would raise
the professional standing of social workers and all those who work in social
services to that anticipated for nurses, doctors and teachers. “The
Conservative approach is to trust professionals to get on with their job with
minimum interference from central government.”

He criticised the government for setting “targets for
everyone but priorities for none” and when it goes wrong, blaming local
authorities.

IT strategy crucial to national service
frameworks

The government’s national service frameworks will
not be delivered without the implementation of the accompanying IT and
information strategy, according to a department of health official, writes
Jonathan Pearce.

"The IT and information strategy is absolutely
essential to the delivery of the national service frameworks. It is hard to see
how it would be delivered without it," said Anne Fletcher, clinical
governance information manager at the doh’s information policy unit.

Information strategies aim to enhance services for users
through the better use of improved information. They have already been
developed for the NSFs for cancer, mental health and coronary heart disease,
and are in the pipeline for older people and diabetes. However, Fletcher said
the department was planning a review of how the strategies worked and linked
with the NSFs.

"It may well be we could integrate the information
strategies into the NSFs, which would be a very useful way forward," she
added.

With the information strategy for older people due in the
next two months, Joan Rawdon, East Riding of Yorkshire Council head of
partnerships and projects, said it would be a question of putting "theory
into practice".

"The national service framework for older people
actually heralds a very distinct change in the way we deliver services to older
people," she said. "The information strategy for older people is very
much about the information helping us provide an information infrastructure and
service to deliver improved services to older people."