Health reforms pose risk to children’s services

The government’s health reforms are already having a negative impact on the commissioning of children’s services and there are fears that GP-commissioning will worsen the situation, according to the Commissioning Support Programme (CSP).

CSP, a delivery partner of the Department for Education and the Department of Health, said local authorities are worried about how GP commissioning will be implemented. There are also concerns over GPs’ lack of understanding of children’s services, partnership working and commissioning expertise.

The body added that relationships with primary care trusts, which had improved over the past two years, were now deteriorating due to reorganisation and cuts to funding and jobs.

“We are concerned that some senior officers and politicians will be tempted to return to old habits of designing and delivering services in silos as they struggle to deal with the financial challenges facing them,” said Lorraine O’Reilly, CSP programme director.

“A rigorous commissioning approach needs to be at the heart of how local authorities, the NHS and their partners in the voluntary and private sectors respond to the new funding realities if we are to continue to drive up outcomes and drive out savings.”

It is a risk highlighted in the interim Munro Review of child protection which stated that the structural changes to education, policing, welfare and health “have the potential to change dramatically the way services interact and support children, young people and families, but they have a continuing crucial role in preventing or responding to abuse and neglect”.

The Association of Directors of Children’s Services agreed, saying the improvement of partnerships had been built on shared priorities and understanding of local need.

“We’ve developed a shared understanding of commissioning, and an increasing mutual understanding of funding and decision making processes within the separate organisations involved,” Marion Davies, ADCS president, told Community Care.

“The transition from this arrangement to new partnerships with GP commissioners needs to be handled very carefully so that these gains are not lost and so that commissioning expertise is retained – this will require close involvement of the local authority and, where they exist, early adopter health and well-being boards so that GPs are supported in understanding, and meeting, the health needs of children and young people in the local area.”

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