Bureaucracy limits joined-up working

Professional boundaries and government
bureaucracy are the main obstacles to further integration,
practitioners told delegates.

Caroline Glendinning from the
National Primary Care Research and Development Centre at Manchester
University, said research on the use of the Health Act 1999
flexibilities revealed several problems at a national

include staff transfers, differing VATregimes and accountability
and performance management.

said:”Local joined-up policies need to be translated into joined-up
policies at a national level.”

Sharma, project director of the North Somerset primary care group,
said a consultation exercise on the possibility of becoming a care
trust had revealed problems around the notion of a single budget.
“We were getting concerns, mainly about funding and that the focus
was on secondary care and waiting lists,” Sharma said.

people wanted was a categorical promise that budgets would remain
the same. But that was counter to what we wanted to do. We didn’t
want to talk about health and social services separately


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