NHS reform threat to joint social care and health working

The government’s NHS reforms risk driving health and social care apart unless action is taken to promote joint commissioning, Association of Directors of Adult Social Services president Richard Jones has warned.

The government’s NHS reforms risk driving health and social care apart unless action is taken to promote joint commissioning, adult care directors have warned.

In its response to the consultation on the NHS White Paper, the Association of Directors of Adult Social Services raised concerns about the possible impact of the abolition of primary care trusts and the transfer of their commissioning responsibilities to new GP consortia by 2013.

It said the change posed “major risks associated with a loss of organisational capacity” at a time when councils faced spending cuts of 25% or more from 2011-15 and the NHS faced having to make productivity gains of £20bn over the same period.

Similar fears were also expressed today by the NHS Confederation and mirror concerns from the King’s Fund, the Royal College of GPs and the British Medical Association about the White Paper.

Adass said it said welcomed the opportunities for councils to take a greater leadership role in health through the establishment within local authorities of health and well-being boards, which will oversee health and social care services in local areas.

But it outlined risks to current joint working and joint commissioning arrangements, including from the dismantling of shared boundaries between councils and PCTs with the creation of GP consortia, which are likely to be smaller than PCTs.

Without such arrangements there could be cost implications to councils, it said, and stressed the need for all partners to be fully engaged in the reform process.

President Richard Jones said: “There is a major need to involve existing and new bodies, local authorities, citizens, local communities and providers in co-designing the changes at national, regional and local levels to achieve a different system that delivers different outcomes across health and social care rather than reinventing the system we have worked in to date.”

The response added that it was vital that incentives were introduced in the forthcoming NHS outcomes framework for GPs to work collaboratively with social care and local authorities and pointed to concerns that smaller specialist services could be decommissioned by GP consortia.

The NHS Confederation outlined similar risks to joint working arrangements and added there was a need to encourage GP consortia to work together and help providers adjust to changes in demand.

Acting chief executive Nigel Edwards said: “It is imperative that the government does everything possible to address what is a significant list of uncertainties about how the new system will work.

“The fact of the matter is that the government is planning to build a very big new machine – at great pace – but no one can be quite sure what will happen when it is switched on.”

Meanwhile, London Councils also backed the benefits of co-terminous boundaries between health and councils in its response to the White Paper.

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