PCT mergers threaten joint working, warn social care leaders

Joint health and social care arrangements are at risk from government plans to merge primary care trusts, sector leaders have warned in a letter to health secretary Andrew Lansley.

The government wants all PCTs to come together in “clusters” with single management teams by June 2011, as a transitional measure ahead of their abolition in 2013, when consortia of GPs will take responsibility for commissioning healthcare.

While the Department of Health’s guidance says it wants joint arrangements to be retained, leaders of councils and individual PCTs with joint management teams, care trusts or other partnership arrangements have written to Lansley to warn that these may be at risk, to the detriment of care.

“The attempt to insist upon a single clustering arrangement across the country places these local arrangements at risk; this risk is made even greater by the pace at which the proposals are being driven through by the strategic health authorities.”

“Should the cluster proposals be driven through unchanged, a number of existing joint working arrangements would lead to be revisited,” the letter added.

The signatories warned that this could increase costs and put service user and patient care at risk. They also questioned why clusters were necessary to achieve the government’s aims of supporting the development of GP consortia.

The letter was signed by Roy Fisher, chair of NHS Blackpool; Peter Callow, leader of Blackpool Council; Malcolm Hanney, deputy leader, Bath and North East Somerset; Joanna Newton, chair NHS Herefordshire; Roger Phillips, leader, Herefordshire Council; Mee Ling Ng, chair, NHS Southwark; Barbara Scott, chair, Bexley NHS Care Trust; and Bill Taylor, NHS Blackburn with Darwen.

“Clustering of PCT management arrangements is an important transitional arrangement to allow new local working structures to develop, ensure continuity of essential functions and reduce administrative costs,” said a DH spokesperson.

“Where there is local integration between current PCTs and local authorities the guidance makes it clear that we want such effective joint working to be sustained as structural change is implemented locally.

“Precisely how this happens varies from place to place, and strategic health authorities and PCTs are working with local authorities to find these solutions within the framework of the guidance nationally.”

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