Blackburn plans to shift services out of acute settings

NHS and council leaders in Blackburn with Darwen are ­planning to use the full integration of health and social care commissioning to shift services out of acute settings and drive efficiencies.

Health secretary Andy Burnham last week gave approval for the creation of a “care trust plus” in Blackburn to replace the existing primary care trust and absorb the council’s adult and children’s social care commissioning role from 1 April. It will be the first care trust to be responsible for children’s social care commissioning.

Janice Horrocks, programme director for the project, said the new organisation, which will have a budget of £350m a year, would shift care out of acute settings into the community and from treatment to prevention.

The care trust plus board will include three councillors, representing the major parties, which Horrocks said would make it easier to win public backing to reshape services.

She added: “Local authorities have a good record of engaging with the community. If we are going to be radical we need to engage and get that mandate from the community because what we need to do might be politically sensitive.”

On the commissioning of children’s social care, Horrocks said council and PCT leaders wanted to “break down the silos” between health and social care and between adult and children’s social services to ensure a less fragmented approach towards families.

She said they believed integration would both improve outcomes and deliver savings, and intended to commission the University of Lancaster to evaluate the new body’s success as soon as it starts work.

Like other PCTs, Blackburn with Darwen is due to divest itself of community health services, leaving the new body, which will have about 250 staff, to focus on commissioning.

The council and the NHS has been working closely together for several years to improve health outcomes. The two funded free use of leisure facilities to residents which, Horrocks said, had led to a big increase in use among some deprived communities.

“We hope we will see more of that kind of activity and using public funding in a more innovative way – perhaps putting funding into social housing,” she said.

Northumberland, North East Lincolnshire, Solihull and Torbay have care trusts responsible for health and adult care commissioning.


Although all three parties are committed to more integrated planning of health and social care, none is calling for more care trusts.

However, the Liberal Democrats are proposing to replace PCTs with health boards, run by councillors and directly elected members, while councils would also get new powers to hold the NHS to account.

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