|
If these buttons don't work, try |
MEETING ON 16 MARCH 2001 AT HALTON
REPORT OF THE CO-ORDINATOR
1. Matter for Consideration:
To report recent developments in relation to Social Services North West's agenda with the National Health Service, notably the conference on Social Care and the NHS Plan and the meeting with the Regional Chair of the NHS Executive
2. Introduction:
Social Services North West has continued to address the new NHS Plan, and the commitment therein to equal partnership between health and social services in delivering the integrated care that people need. Members and officers are working hard on these issues in their authorities, and this report details the further actions being taken by Social Services North West to support them in this task.
3. Information:
3.1 Since the last progress report , two major events have taken place. The first was the major conference held at the Reebok Stadium, Bolton on 18 January. Around 80 delegates heard all the speakers emphasise in different ways the vital contribution that local government in general, and social services in particular, has to make if investment in the nation's health is to have the necessary impact.
Councillor Cliff Morris, Chair of Social Services North West in opening the conference, said that the partnership between Social Services and the NHS is absolutely the Number 1 policy topic. The NHS Plan, and the massive increase in resources accompanying it, provide an exciting springboard for real advances in the quality of care.
3.2 The first address, on 'Modernising Social Services and Health - Six Months on from the NHS Plan' was given by Professor Gerald Wistow, Director, Nuffield Institute for Health, University of Leeds. He began by reviewing his paper The Modernised Social Services - NHS Handmaidens or Partners in Citizenship, prepared for ADSS in August 2000. He reviewed the key elements of public sector modernisation, with particular reference to local government and the NHS, comparing these with certain trends in public health policy which had a different emphasis. He examined the expectations of social care services set out in the NHS Plan, but asserted the wider role of social services in empowering vulnerable people, mobilising community resources, and promoting holistic governance to meet the holistic needs of individuals in their communities. He then reviewed developments during the last six months, including the unification of the NHS and social care within DH, the Modernisation Board and Implementation Plan, and the Health and Social Care Bill. In the wider sphere of community leadership could be found community strategies, neighbourhood management and the NHS scrutiny role. He identified events still to come and issues still to play for. A review of current opportunities and threats led to two possible alternative scenarios for health leadership in the future, and some strong conclusions: prevention is better than cure; structures should support pre-identified processes and not vice-versa; and localised engagement and control are elements of healthy living.
3.3 Peter Rowe, Director of Primary and Community Care, North West Regional Office, NHS Executive then spoke about 'Implementing the NHS Plan in the North West'. He addressed his subject under four main headings: the vision; structural changes; the modernisation architecture; and targets for 2001. The three key elements of the vision were: accessible services, quality assured and accountable, and integrated. The structural changes would involve many fewer health authorities, the end of PCT's community trusts and CHCs, and the development of Primary Care Trusts and Care Trusts. Peter described the architecture of modernisation and the targets to which it was dedicated. He concluded that there was a massive change agenda and the pace is accelerating. He and his colleagues are genuine about partnership - but know we must do better!
3.4 The topic 'Mental Health: New Plans and New Partnerships' was addressed by Peter Clarke, Director of the North West Mental Health Development Centre, and colleagues Helen Lasham and Lily Reid. Peter Clarke opened the presentation by saying that it would be about a challenge to the system: above all, mental health services have to be about outcomes for people. He looked at changing concepts of mental health and mental illness: the large institutions have closed, but illness is still seen outside the context of living life; there are still piecemeal responses to needs, and there is still an emphasis on service outcomes, not life outcomes. New plans and partnerships are needed to deliver outcomes in the life experience of individuals and communities, to sustain citizenship and secure inclusion. Peter's remarks were powerfully reinforced by the personal experiences of Helen Lasham, who had used mental health services, and Lily Reid whose son has a serious enduring mental illness. Peter then asked how we could move from the old divisions and achieve vision, leadership, strategy and connection. How do you enable your local system to work to achieve outcomes, deliver best value and maintain standards, with people and their life context at the centre? That is the challenge to the mental health system, to achieve better outcomes at the levels of the individual, the neighbourhood, the authority and the region.
3.5 The final address, 'Investing for Better Health', was given by Kath Reade, Chair of East Lancashire Health Authority and a member of the North West Development Agency. She spoke of multi-agency, multi-sector partnerships across the region, which is how we need to operate if we want to make a real difference. The North West Strategy pledges to integrate three cross-cutting issues: social inclusion, health and sustainable development. This is based on the WHO Verona Challenge, which sees a triangular interdependent relationship between economic, social and health development. Healthy people are more productive, make fewer demands on the health and social care systems, and have more opportunities to participate in social and economic life. Kath went on to describe a number of initiatives she is involved in, both regionally and sub-regionally, to take forward this vision. She also spoke from her own past experience of how working with people to improve provision in communities can transform their lives. She ended with a powerful call to us all to play our part in challenging the causes of poverty, injustice and inequality, and improving health across the North West.
3.6 In closing the conference, Ken Foote, Director of Blackburn with Darwen and Chair of ADSS NW, said how he and others had been energised and inspired by the conference speakers to renew our efforts to work with colleagues in the NHS and local government, to bring about the best possible outcomes for people in our communities. A full report of the Conference is available on request.
3.7 This commitment was carried forward into the second in a series of meetings held by Social Services North West Chair Cliff Morris and Vice Chair Brian Strett with Professor Joan Higgins, Regional Chair of the NHS in the North West at Bolton on 6 February. Accompanied by Conservative spokesperson Chris Holtom and officers of SSNW and ADSS NW, members reviewed progress on the reconfiguration of NHS organisations (especially Primary Care Trusts and Health Authorities); the emergence of specialist Trusts for Mental Health; the developing position concerning Continuing / Intermediate Care and Performance Assessment; identifying the NHS resources applied to Social Care, and implementing the NHS Plan (especially Care Trusts). Members were pleased to note progress in a number of areas since the previous meeting, in particular the development of closer joint working at local level. The minutes of that meeting are attached as an Appendix to this report.
Click here to read the minutes of the meeting between representatives of Social Services
North West and the NHS Executive North West, held at Bolton Town Hall on 6 February 2001
3.8 Professor Higgins' role as Regional Chair ceases this month as new arrangements are made for non-executive
appointments to the NHS. Members may wish to raise with the Regional Director the continuing need for periodic
high-level contact between Social Services North West and the NHS Executive North West.
3.9 Now that such encouraging progress is being made on detailed joint working arrangements across most, if not
all, of the Region, the major new issue in relation to joint work with the NHS would appear to be the arrangements
for the new form of joint organisation envisaged in the NHS Plan, the Care Trust. The issue is being hotly debated
as the Health and Social Care Bill moves through Parliament. The Bill's plans for merging adult health and social
care services in care trusts pose "fundamental problems", according to a joint letter sent by eight organisations,
including the LGA and ADSS, to health minister Lord Hunt. Most important is "a significant risk that the broadly
based community and social care model will lose out to a medical/clinical approach", say the eight signatories.
"Users' organisations believe that this may jeopardise the principles of social inclusion and enhanced independence
which lie behind social care, and undermine the invaluable contribution of services which do not equate disability
and old age with ill health." The authors say that "hard-won principles will not survive unless any
new bodies are truly joint … [and] reflect an equal partnership," rather than being NHS organisations, as
currently planned. The letter also calls for "real debate" on matters such as accountability and funding.
"Service users must be clear about who is responsible for their care," it says. "This will not require
only transparent complaints procedures, but governance and management arrangements that enable local councils to
maintain proper democratic accountability to local people for the services they delegate into the care trust."
3.10 Members may feel that Social Services North West could usefully examine the Care Trust concept in more detail,
through a group of officers (and members if desired). This group could come forward to the next meeting with recommendations
about how, within the legislation as it emerges, NHS organisations and local authorities can progress their joint
arrangements in ways which build upon the strengths which both the NHS and local government bring to the table
and which focus on the needs of service users and carers in their local communities.
4. Recommendation:
4.1 That the report be noted.
4.2 That the Regional Director of the NHS Executive be approached about the need for continuing periodic high-level
meetings between the Executive and Social Services North West into the future.
4.3 That a Working Group be established on how, through Care Trusts and other mechanisms, local authorities and
NHS organisations can build on present joint arrangements for the benefit of service users and carers in their
local communities.
|
Clicking on these links will help you to use SSNWeb, |