Social care not marginalised says NHS chief

The restructuring of the department of health is not about
marginalising social care, but ensuring wider understanding of the
issues that affect the sector, according to NHS chief executive
Nigel Crisp, writes Lauren Revans.

Describing the change as “behavioural rather than
structural”, Crisp promised that there would still be
“someone senior” from social services in the new-look

The change outlined last month will see the doh split into three
divisions, none of which will be headed by a professional with a
social care background. One – the health and social care standards
group – will be led by chief medical officer Liam Donaldson, who
will have a team of three including one responsible for social
care. The Social Services Inspectorate will no longer sit within
the department.

Crisp told the Association of Directors of Social Services
spring seminar that the rationale behind the change was to move
understanding of the social care sector from the hands of the few
into the hands of the many. He added that moving the SSI out of the
department to be merged with the majority of the National Care
Standards Commission to form the independent Commission for Social
Care Inspection would also “build confidence” in the
social care system.

Despite his only praise for the sector being reserved for its
role in helping hospitals meet their targets on delayed discharges
and A&E waiting times, Crisp denied there was too much focus in
the department and the NHS on acute targets. But directors insisted
that the obsession with acute trusts was hindering joint

Directors vehemently rejected Crisp’s suggestion that jobs
in the social care sector were often filled via informal networks.
They also dismissed as unhelpful and inappropriate his comments
about using the seminar to recruit directors to work in the NHS,
and his boasts of how many had been poached to date.

Responding to Crisp’s speech, Wiltshire social services
director Ray Jones said: “There is concern around the
restructuring of the doh and whether it is going to leave social
care more and more marginalised. Your NHS-centric presentation this
morning suggests this is even more of a concern than it might have

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