Editorial Comment: Vision’s flawed focus

Like him or loathe him, Alan Milburn MP was the only visionary to have been health secretary in recent times. And, when it came to better integrating delivery of health and social care, ambitious new care trusts were his solution. They would bring many of the responsibilities for primary care and adults’ services under one roof.

While few disagreed with the principle, many took issue with the prescriptive structure. Only 10 exist and they vary in their roles, with half providing services only. But with another planned, and a commissioning framework due for health and well-being from the government next month, care trusts are back in the spotlight.

The Commission for Social Care Inspection’s recent report into the first care trust is essential reading.

Set up in Northumberland to support more innovative and integrated working, health priorities have dominated at the expense of adults’ services. Enormous effort went into creating the trust, but this wasn’t matched in developing frameworks and partnerships to deliver the aims.

Organisational culture is as important as structure. Those considering this care trust model will have to ensure that their strategic priorities are owned – and balanced – locally, otherwise the vision will remain just that.

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