Lewis calls to switch commissioning to councils in wake of abuse report

Local government looks set to assume commissioning responsibility for learning difficulties services in England after last week’s scathing report into NHS-purchased services.

Care services minister Ivan Lewis made the call to transfer responsibilities from the NHS in the wake of last week’s Healthcare Commission report, which identified “institutional abuse” in services provided and commissioned by Sutton and Merton Primary Care Trust.

He said: “We’re seriously looking at transferring responsibility from the NHS to local government for this kind of care because most of it doesn’t require health care.”

The move is being considered as part of a review announced following last year’s even more scathing report into services at Cornwall Partnership NHS Trust, which is due to report in the spring. Lewis said he believed “this is the right way ­forward now”.

Services at Sutton and Merton PCT were commissioned by the trust itself and other PCTs, while provision in Cornwall was also commissioned solely by PCTs.

Following the Cornwall report, the county’s PCTs admitted they had “historically lacked expertise” in commissioning learning difficulties services, while Sutton and Merton PCT is planning to transfer its commissioning responsibilities to the area’s two local authorities.

In most parts of the country services are either commissioned jointly by councils and PCTs or councils take lead responsibility through pooled budgets. Lewis’s comments signal that the two options will become universal in England.

Rob Greig, national director for Valuing People, said: “The key outcomes in Valuing People are about citizenship and inclusion and these are responsibilities that rest with the local authority. Sutton and Merton PCT recognised that it, as a PCT, was not equipped to commission on citizenship and inclusion.”

Jo Webber, deputy policy director at the NHS Confederation, said it was vital that services were commissioned in partnership, but added that it should not matter whether PCTs or councils took the lead.

NHS responsibilities
The NHS spends more than £2bn a year on learning difficulties services. The largest proportion is transferred to councils under agreements. The rest is used to commission social care, to buy specialist health care and on services in long-stay institutions.

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Mithran Samuel

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