Edited by Jon Glasby and Edward Peck.
Radcliffe Medical Press
Glasby and Peck have succeeded in tracing the genesis of care trusts as a presumed structural solution to the Berlin Wall between health and social care, and in tracking the real difficulties in translating the concept into reality. They are aided by a judicious mix of contributors from both operational management and the academic world.
An interesting chapter by Glendinning, Hudson, Hardy and Young maps the success of section 31 flexibilities in building a sense of shared endeavour and enhancing staff morale. But evidence from care trusts themselves is far more ambiguous. Somerset, widely seen as the forerunner of the new care trusts and presented as a good practice model in the NHS Plan, reported a worsening of job satisfaction, morale and role clarity in the years immediately after the integration.
The editors have done a service to all those contemplating structural change. They argue that care trusts will work only when they flow from a basis of understanding and build on successful partnerships. Section 31 agreements can deliver real change without posing a threat to professional identity. If what matters is what works, there is more than one way to work in partnership.
Terry Bamford is a member of the General Social Care Council and chairperson, Kensington and Chelsea Primary Care Trust.