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Appendix D
Department of Health Consultation on
Shifting the Balance of Power in the NHS – Securing Delivery
RESPONSE OF SOCIAL SERVICES NORTH WEST
Social Services North West is the member-level body which represents the local authorities in the North West of England which have responsibility for the personal social services. Its membership and aims and objectives are given at the foot of this paper.
Social Services North West welcomes the principles underpinning Shifting the Balance of Power in the NHS – Securing Delivery, and its companion which addresses the reform of the Department of Health itself. Particularly welcome are the commitments to supporting delivery at the front line, and to encouraging partnerships in health and local government to ensure integration between health and social care. These are commitments which we share.
We are uneasy about the rapid and radical change which is planned to take place simultaneously at all four levels in the NHS – national, regional, sub-regional and local. This rapid pace of change is bound to lead to instability within the leadership and management of the NHS, and deflect attention from the many demanding targets currently facing the health and social care system. Whilst the changes are being made, it will be essential for all NHS staff to remain focussed on the need to maintain adequate delivery in the short term, as well as improve delivery in the longer term.
Concerning the Strategic Health Authority tier, the proposals for the North West largely correspond to the plans already being made for health authority mergers, and they respect the important principle of coterminosity to a large degree. Indeed, at PCT level, there will be a welcome improvement in coterminosity in most of the metropolitan districts. In Liverpool and Manchester, however, greater complexity will result from several PCTs needing to relate to a single social services authority, as also in the counties.
We welcome the devolution of a large proportion of NHS budgets to PCTs, and their key role in local planning. In the short term, however, management and leadership capability at PCT level will be a key issue. Nevertheless, our member authorities are involved in (and often leading) a rapidly increasing number of joint projects between health and local authority services using Health Act flexibilities, and joint managerial appointments for key areas of service.
We see such voluntary partnerships as key to the successful integration of health and social care at the point of delivery to service users. The need for secure resourcing arrangements to underpin these partnerships is vital, but subject to this, voluntary local agreements will achieve far more than centrally-imposed arrangements, be they Care Trusts or otherwise. Central Government already has enough levers to secure service improvement locally (Audit Commission, Social Services Inspectorate, Commission for Health Improvement, National Care Standards Commission etc), and imposesd solutions would not create the right climate for further improvement.
We welcome the recognition that local government has much to bring to the table where promoting the well-being of individuals, families and communities is concerned. Whilst social care may be the largest local government contributor to the joint agenda with the NHS, many other services have their own important part to play: houising, education, environmental health, local advice and benefits services, community safety and, not least, Community leadership and Local Strategic Partnerships.
There is a need to develop more models of ‘what works’, and the means of spreading good practice. There must be a focus on the wider preventive agenda, involving local government and primary care as key players. The arrangements for overview and scrutiny of the NHS by local authorities need more work, as do those for public and patient representation in relation to NHS bodies. For this reason, Social Services North West is developing links with the regional association of CHCs, in the hope that their expertise and commitment can be carried over and enhanced within the new system.
Social Services North West has valued its working relationship over many years with the North West Regional Office of the NHS Executive, and this continues as close as ever today. We hope to develop equally close links with the new Regional Director of Health and Social Care, as well as with the three Strategic Health Authorities in the North West.
We assure the Department of Health of our commitment to maximise the partnership between health and social care at every level within the North West, and hope to be able to operate within a framework of constructive co-operation towards our shared objectives.
Councillor Cliff Morris
Chair, Social Services North West
Social Services North West works with its members and others to promote high quality local authority services in the North West of England by
- considering issues relating to the personal social services which are of regional or sub-regional significance, and making recommendations to member authorities.
- promoting good practice in the personal social services amongst member authorities.
- making representations to Government on behalf of member authorities on the implications for the North West of Government policies for the personal social services and related matters.
- working with other regional and national bodies on behalf of member authorities to promote high quality public services.
19 of the 22 eligible authorities are in membership: Blackburn with Darwen, Blackpool, Bolton, Bury, Cumbria, Halton, Knowsley, Lancashire, Liverpool, Manchester, Oldham, Rochdale, Salford, St Helens, Sefton, Trafford, Tameside, Warrington and Wigan.
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