‘Pool the commissioning of children’s health and social care’

All commissioning for children’s health and social care services in England should be pooled and delivered by local partnerships, a government-commissioned report has said.

Sir Ian Kennedy’s review of NHS services for children found quality was being undermined by a lack of co-ordination between services and a failure to share information between agencies.

“At the local level, agencies engaging with children need to have a common agenda and all the commissioning for health and social services should be done through one body,” Kennedy said at the launch of his report in London today.

“The history of the NHS with child protection and safeguarding is one of a rather patchy engagement and that needs to change.”

This common agenda could be achieved by local partnerships, Kennedy said, a new concept which would bring together local authorities and other agencies concerned with the welfare and care of children and young people in a particular locality. The agencies would then be able to agree how the respective services that they provide should be delivered.

Kennedy’s report, Getting it right for children and young people, found widespread variations in the quality of children’s health services across the country, and parents and carers were often frustrated at the lack of co-ordination between services.

“Many people who work in and use the NHS would agree that the services provided do not measure up to the needs of children and young people. They are not good enough in a number of ways,” it said.

The review concluded that better communication between health and social care was key to bringing down the number of child protection cases.

“A major complaint raised against the NHS is its poor performance as a partner in joint activities with other agencies,” the report said. “This is so even when its participation is required by law.

“PCTs are currently described as the local bodies least engaged with Children’s Trusts and safeguarding boards. The police have described the NHS as its weakest partner. Others have described the isolation of the NHS in terms of ‘fortress health’.”

The NHS Confederation has agreed that better working around child protection is necessary.

“For cases where abuse is concerned, like the tragic death of Baby Peter, the NHS needs to play its part in ensuring everything possible is done to make sure hospital doctors, nurses and GPs are aware of things like the history of previous injuries, police or social services visits or family problems,” said Nigel Edwards, director of policy at the NHS Confederation.

Ministers have yet to respond to the report’s recommendations.

It follows the government’s NHS White Paper, published in July which will give local authorities statutory responsibility for bringing health and social care together.

Consortia of GP practices will take on responsibility for commissioning most health services from primary care trusts (PCTs), which are being abolished. Councils will take on PCTs’ public health functions and be charged with leading the integration of health and social care locally.

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