Five multi-million pound health and social care partnerships in Glasgow collapsed this week following a dispute between the council and the local NHS board over their future direction.
NHS Greater Glasgow and Clyde decided to scrap the community health and care partnerships (CHCPs), which have integrated commissioning and provision in local areas since 2006, and replace them with arrangements covering healthcare alone.
The move, made by the board’s performance review group, was based on Glasgow Council’s decision to go back on an agreement to devolve social care budgets and management responsibility in full to the five partnerships by April 2010.
While NHS Greater Glasgow and Clyde had devolved decision-making responsibility and health budgets now worth about £500m a year to CHCPs from the start, the council had retained some money and control centrally.
In December last year, both sides agreed to full devolution of council budgets to the CHCPs by April 2010, which would have increased the authority’s contribution from about £180m to £400m a year.
However, last month, the council decided that this would pose too great a financial risk because it would prevent the authority from offsetting overspends by CHCPs centrally.
The council also cited an inspection report on Glasgow by the Social Work Inspection Agency which had advised the authority to retain a “strong strategic core” in social work to ensure that CHCPs do not result in “unacceptable differences” in service quality across the city.
The council proposed a series of incremental measures to devolve responsibility to CHCPs. However, the NHS board said this would not offer a “viable way forward”.
A report to a performance review group meeting this week said that without full devolution, CHCP management teams would continue to be unable to take decisions on cases without having to refer them to Glasgow’s social work department.
By lacking responsibility for the totality of resources in their localities, CHCPs were also unable to make significant changes to services, for instance shifting the balance of care from institutions into the community, it said.
It added: “The NHS board has no option but to consider how it can move to establish stable and viable organisational arrangements to replace CHCPs.
NHS Greater Glasgow and Clyde’s next full board meeting in June will consider recommendations on setting up health-only arrangements, with a view to ending CHCPs by October.
However, a spokesperson for the council said: “The council is completely committed to joint working with the NHS and on CHCPs in particular. We are committed to devolving budgets to the CHCPs, albeit not as immediately as the NHS would like. Therefore it is a matter of great regret that NHS GGC has decided to unilaterally bring this arrangement to an end.”