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SOCIAL SERVICES NORTH WEST (NWASSA)
MEETING ON 15 DECEMBER 2000 AT BLACKPOOL
REPORT OF THE CO-ORDINATOR
WORKING WITH THE NATIONAL HEALTH SERVICE
1. Matter for Consideration:
To report recent developments in relation to Social Services North West's agenda with the National Health Service
2. Introduction:
Social Services North West has warmly welcomed 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 On 7 November 2000, Minister of State John Hutton wrote in reply to the Chairs's letter of 28 June, which had
expressed concern about the NHS Confederation's proposals that the NHS should take over the commissioning of social
as well as health care for older people. The reply sets out the NHS Plan's visions for the development of Care
Trusts:
"As outlined in the NHS Plan, our vision for a local Care Trust is that by agreement with the relevant local
council, these single multi-purpose bodies will be able to commission all community care services for older people
and perhaps for those with mental health problems. We will issue new statutory regulations setting out the governance
arrangements of Care Trusts to ensure a better balance between health and social care partners."
3.2 Social Services North West has welcomed the concept of a Care Trust, based on voluntary partnerships between
local authorities and the NHS. It is therefore regrettable that our letter was misinterpreted as being critical
of the concept, when all we were advising against was the NHS Confederation proposal of an NHS takeover through
legislation of the commissioning of social care for older people.
3.3 At the October business meeting, members approved a Policy Briefing on Working with the NHS which identified
the following concerns amongst member authorities:
· Extra resources allocated to the NHS to cope with such issues as winter capacity and intermediate care
are not always addressing the total health/social care system
· Rapid organisational change in the NHS is inhibiting its capacity to address both planning and operational
issues on a partnership basis
· The continuing care agreements reached in the early 1990s are in urgent need of review, but this is not
seen as a priority by the NHS in the North West
· Planning the future of mental health services particularly demands a partnership approach between health
and social care which is not always acknowledged
· The NHS Plan is dominated by issues of acute care and the need to address the wider context of health
inequalities
3.4 The following actions were agreed:
· In a spirit of partnership with the NHS, we will continue to urge that we are treated as equals in the
single health and social care system, regionally and locally
· We urge a recognition that the welcome additional Government resources should be allocated with the total
health and social care system in mind
· We reject enforced organisational change as a route to integrating health and social care
· We will press for a joint approach in key areas such as mental health and intermediate care
3.5 To pursue these aims and to further our own understanding of the issues, it was agreed to hold a conference
in January 2001 for members, Directors and relevant senior officers. This has now been arranged for 18 January
at the Reebok Stadium Bolton, with a strong and varied line-up of speakers - see Appendix 2. It is hoped that there
will be a strong turnout of both members and officers for this major opportunity to learn of national developments
and to shape our planning within the region. Members may also wish to invite colleagues from NHS organisations
in the region to share the day's thinking.
3.6 Members will recall the very positive meeting that leading members of Social Services North West had with the
Regional Chair of the NHS Executive North West in July. It is pleasing to report that her officers have instigated
a follow-up meeting and this will take place in Bolton Town Hall on 6 February 2001. Agenda items already identified
include updates on issues such as reconfiguration of NHS organisations, mental health, continuing/intermediate
care, performance assessment and resource allocation, but members may wish to identify other issues to be taken
up at this meeting, such as implementing the NHS Plan, with particular reference to Care Trusts, and the identification
of resources for social care.
4. Conclusion
Social Services North West, having established itself as a significant player at regional level with NHS colleagues,
has already taken the steps outlined above to support member authorities in meeting the Government's expectations
of the health and social care system. Members are invited to identify any further ways in which the organisation
can support their endeavours.
5. Recommendation:
5.1 That the report be noted and the actions already taken be endorsed
5.2 That further tasks be identified for Social Services North West to undertake in support of member authorities,
in relation to the NHS Plan.
APPENDIX 1
From the Minister of State, Department of Health
Richmond House
79 Whitehall
LONDON
SW1A 2NS
Tel 020 7210 3000
POH (4)1689/1848
TO 2000/22994
07 Nov 2000
Councillor Cliff Morris
Social Services North West (NWASSA) Office
Room 223
Social Services Headquarters
PO Box 162
East Cliff County Offices
Preston
Lancashire PR1 3EA
Dear Councillor Morris
Thank you for your letters of 28 June to myself and Alan Milburn expressing your concerns about this Government's
proposals in services for older people. I am sorry you have not received an earlier response.
The Government has taken great strides to establish and develop Primary Care Trusts (PCTs). We believe that PCTs
are ideally suited to offer flexibility in commissioning and providing services to their local population. The
40 existing PCTs are already developing strong relationships with the local communities they serve, identifying
specific local needs and adjusting service provision within their locality. PCTs undoubtedly offer an unparalleled
opportunity for primary care professionals to shape and improve local health services by identifying specific local
needs for patients and working with Social Services, Voluntary Organisations, GP practices and secondary care providers
to meet specific needs or adjust service provision within their locality. Effective partnership working across
the whole local health economy is crucial to the success of each PCT. Many of the existing PCTs are already making
best use of the partnership powers in the Health Act 1999 and commissioning both health and social care for older
people by PCTs would impede the development of high quality services for older people.
We have consistently emphasised that one of the essential criteria for moving to PCT status is that the process
must be locally driven, achieve benefits for local services and echo local views. It is therefore logical and important
that decisions to provide and commission local services, including those for older people, are made with all local
agencies to promote joined up working and an integrated approach to delivering care.
It is for this reason that there is a reserved position for a nominated Social Services Officer on the Executive
Committee of PCTs. Social Services Officers may also be represented as lay members on the PCT board. We believe
this is the best way to ensure effective social services input. I am pleased to learn that a number of PCG/Ts are
reporting effective co-operation with Social Services.
I wholeheartedly agree that local Social Services authorities have a vital role to play in arranging and providing
social care services for the ill or disabled. I cannot, however, agree with your assertion that this Government's
plans for effective joint working between the NHS and local authorities is not the way forward. We are taking great
strides to create a more integrated system for the delivery of health and social care, particularly for older people
and those with mental health problems. As outlined in the NHS Plan, our vision for a local Care Trust is that by
agreement with the relevant local council, these single multi-purpose bodies will be able to commission all community
care services for older people and perhaps for those with mental health problems. We will issue new statutory regulations
setting out the governance arrangements of Care Trusts to ensure a better balance between health and social care
partners. Where local health and social care organisations have failed to establish effective partnerships or there
is clear evidence of failing services, we will take statutory powers to establish a Care Trust. Care Trusts will
commission social care services under delegated authority from the appropriate local council, which will retain
the statutory accountability. This will build on the Health Act flexibilities under which Health and Local Authorities
can, for example, pool their resources into a single budget to secure more integrated purchasing of care packages.
Intermediate care is a new tier of services which will provide high quality care closer to home, helping older
people avoid unnecessary hospital stays and promoting active rehabilitation and recovery. By 2004, we will be making
available an extra £900 million for services to help older people live independent lives at home and improve
the quality of care. A significant proportion of this investment will be used to create new intermediate care services
for up to 150,000 more people each year, through around 6,500 extra beds and 1,750 supported places in the community.
This investment will also be used for a major expansion in rapid response services and other schemes designed to
help up to 70,000 people stay out of hospital each year.
In closing, I reiterate that truly effective joint working with Local Authorities, Social Services and other local
key stakeholders is vital to the modernisation of the NHS in delivering better healthcare for all its patients.
I would of course be delighted to be provided with further information about Social Services North West.
Yours sincerely
JOHN HUTTON
APPENDIX 2
ADVANCE NOTICE: JOINT CONFERENCE BETWEEN
SOCIAL SERVICES NORTH WEST AND ADSS NORTH WEST
SOCIAL CARE AND THE NHS PLAN
equal partnership in serving people and communities
Thursday 18 January 2001 - Reebok Stadium, Bolton
Social Services North West has welcomed the NHS Plan as the most fundamental reform of health and related services
for over fifty years. Achieving the vision of an integrated approach to health and social needs is not going to
be easy, and there are further challenges: to focus on the needs of users and their carers and to link to the related
agendas of regeneration, social inclusion and sustainable development.
This conference brings together experts and champions of these issues to engage with members and officers from
North West authorities. Presentations will include:
MODERNISING SOCIAL SERVICES AND HEALTH -
Six months on from the NHS Plan
Professor Gerald Wistow, Nuffield Institute for Health, University of Leeds
IMPLEMENTING THE NHS PLAN IN THE NORTH WEST
Peter Rowe and Hilary Blumer, North West Regional Office, NHS Executive,
MENTAL HEALTH: NEW PLANS AND NEW PARTNERSHIPS
Peter Clarke, Director of the North West Mental Health Development Centre and colleagues
INVESTING FOR BETTER HEALTH
Kath Reade, Chair of East Lancashire Health Authority and a member of the North West Development Agency.
Full details and booking forms for the conference will be circulated shortly, but
PLEASE BOOK THE DATE NOW!!
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