Adult social services directors critical of standard contract

A new standard contract for mental health and learning disability services in England will fail to adequately support integration between health and social care, sector leaders have warned.

The Standard NHS Contract for Mental Health and Learning Disabilities comes into effect in April for one year. It will create legally binding agreements between care providers and primary care trust and local authority commissioners, in order to commit them to specific policy objectives and ensure accountability. However, existing arrangements can continue until April 2010 where contracts are well-established.

The Association of Directors of Adult Social Services welcomed a standardised approach to joint commissioning, saying it was a vital step towards achieving fully coordinated services across health and social care.

But Mark Jordan, head of joint commissioning at Hertfordshire Council, speaking on behalf of Adass, said the contract lacked clear guidance for local authorities seeking to strengthen partnerships with PCTs.

Steve Shrubb (pictured), director of the NHS Confederation’s Mental Health Network, which represents the majority of mental health trusts in England, queried the lack of progress made in developing the contract.

“We’ve got the legal terms and conditions but not what we want to achieve, how to achieve it, and the quality indicators,” he said.

“The vast majority of mental health care is provided by an integrated service between health and social care. The Department of Health failed to realise those aspects required far more development within the contract until it was too late.”

The contract requires partner agencies to work towards six policy targets, including reducing admissions of 16- to 17-year-olds and mixed sex accommodation in adult psychiatric wards, adopting the care programme approach in care planning, and producing quality improvement plans in each area.

Shrubb said a more comprehensive “model contract”, which will govern arrangements in the longer term, may improve arrangements, but added that “we could have been in this place 12 months ago”.

• Contract guidance

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