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Meeting between Representatives of Social Services North West and the NHS Executive North West, held at Bolton
Town Hall on 6 February 2001
Present
Professor Joan Higgins - Regional Chair, NHSE (NW)
Councillor Cliff Morris - Chair, SSNW
Councillor Brian Strett - Vice Chair, SSNW
Councillor Chris Holtom - Minority party representative, SSNW
Peter Rowe - Director of Primary and Community Care, NHSE (NW)
Hilary Blumer - Head of Health Partnerships with Social Care, NHSE (NW)
Paul Brearley - Assistant Chief Inspector SSI (SCR(N)
Ken Foote - Chair, ADSS NW Branch
Bernard Walker - Secretary, ADSS NW Branch
Peter Hewitt - Co-ordinator, Social Services North West
Peter J Viggers - Professional Assistant, SSNW
Apologies
Councillor Frank Roderick - Minority Party representative, SSNW
1. Minutes of the meeting held on 10 July 2000 and matters arising:
Peter Rowe pointed out, in reference to paragraph 3, that there are in fact three Primary Care Trusts in Manchester.
Matters arising would be dealt with on the current agenda.
2. Reconfiguration of NHS Organisations:
2.1. Primary Care Trusts: Peter Rowe said that there were 6 new PCTs up and running: three in Manchester;
Trafford South, Blackburn with Darwen and Morecambe Bay ( though this is not yet operational). Another nine should
be operative in the next five or six weeks - these are: Salford, Trafford North, Stockport, Heywood and Middleton,
Chorley and South Ribble, West Lancashire, Southport and Formby, Bootle and Litherland, and West Wirral. Tameside
and Glossop, along with Oldham, need more time and are to re-submit. Another PCT for mid Sefton is also to be established.
The whole of the Region should be under PCTs by April 2002. Councillor Holtom asked about possible delays and Peter
Rowe said one or two might take as long as April 2003 or even 2004. Professor Higgins said that that there will
be an independent Appointments Commission for Chairs and non executive Directors from April 2001, when her role
will cease in its present form. Councillor Holtom raised the matter of eligibility for applications to serve on
Trust /Health authority boards. Professor Higgins said that there was normally an expectation that people live
in the area; length of service would be for a term of up to 8 or sometimes 10 years.
2.2. Health Authorities: Peter Rowe said that - as stated at the previous meeting - there would be
fewer but larger health authorities, for instance a Lancashire/ South Cumbria configuration was being considered,
North Cumbria may also be brought into the NW fold. Peter Milnes had been appointed as project leader to look at
a new pattern for the Greater Manchester area, and Tony Gick in relation to Lancashire/South Cumbria. Regarding
the Mersey Region, a project leader had still to be appointed there. Ken Foote expressed concern about the rate
and scope of change and its impact on stability and capacity. At this time of change in the NHS, social services
authorities were keen to help in any way they could eg through joint OD programmes, joint appointments etc.
3. Mental Health
3.1 Mental Health Specialist Trusts are being considered in various parts of the region. In Morecambe
Bay, mental health is within the PCT, and the joint service in Manchester is already set up. Plans are advanced
for Liverpool / Sefton / Ashworth Hospital, whilst plans for the following configurations are being discussed:
Bury / Rochdale / Oldham / Tameside; Lancashire; Knowsley / St Helens / Halton/ Warrington / Wigan; and Salford
/ Trafford / Stockport / Bolton. There was agreement that the appointment of Eddie Kane as Regional Director is
helping to drive matters forward, and Bernard Walker underlined the importance of the links to Social Services
and the wider role of local government. He hoped this would be reflected in the governance arrangements of these
new bodies.
3.2. Learning Disabilities: Councillor Holtom asked about the future of Learning Disability services.
Hilary Blumer referred to discussions with Ian Davey of Rochdale and others, in relation to the White Paper expected
in March 2001. It was recognised that there was a need for a joint implementation exercise regarding adults and
children with Learning Disabilities. Peter Hewitt stated that SSNW/NWASSA had had a long history of proactive involvement
in this field, and that a conference could be organised looking at issues around corporate responsibility.
4. Continuing /Intermediate care:
Peter Hewitt reminded the meeting of the need to review the Continuing Care agreements, which were increasingly
outdated in view of recent changes in practice. The latest developments were discussed, including the recent circular
on intermediate care. There were still unresolved issues at ground level and Ken Foote said he would like to see
more progress on reviewing the continuing care criteria, with regard paid to the National Service Framework in
relation to Older People. The issue of the funding of, and charging for, nursing and personal care was also discussed.
Professor Higgins said that these issues were already under discussion in the NHS, this would need to continue
to be reviewed jointly at regional and local level.
5. Performance Assessment:
Peter Hewitt said the previous meeting had discussed the need to refine the performance measures in both services
and to enable them to mesh together more effectively. Hilary Blumer said that the NHS Region and Social Care Region
have set up a "think tank". Data will be pooled re PAF where appropriate and some good shared working
is already happening, with local authorities especially good at qualitative data and health at the quantitative.
It was agreed that the changing scene at the local health economy level was key in aiding understanding of the
data. Bernard Walker said that the invitations to SSD Directors to briefings on the SAFFs (Service and Financial
Frameworks) had been very helpful, and that the implications for social services, and local government generally,
were now clearer. Councillor Strett said that close working between health and social services was of great importance
given the huge agenda. Paul Brearley said that the SSI has set up additional SCR regions, co-terminous with health
regions, and a new Assistant Chief Inspector will be appointed in the North West, who will sit on the NWRO Executive
Board. There is now better national data about interface issues, and we have moved from managing boundaries to
joint management of shared areas of responsibility. The Best Value approach was relevant to the PAFs in both health
and social services. Peter Hewitt referred to the annual review meetings now being held as a way of pulling the
various strands together. Reference was made to the forthcoming workshop at Warrington, and Hilary Blumer confirmed
NHS involvement in this. Peter Hewitt said there could be a Social Services North West event later in the year,
and NHS involvement in this was promised.
6. Identifying NHS resources applied to Social Care:
There were encouraging signs that in recent months the sharing of resources for issues of joint concern (eg winter
pressures) seems to have been working better at local level. Peter Rowe said that the NHS executive is very keen
to see that there is effective co-operation; the available data backs up the overall impression of successful sharing:
Bernard Walker concurred that this was so, underlining the continuing need for transparency in these matters.
7. Implementing the NHS Plan:
7.1 Modernisation Board and Task Forces: The Regional Modernisation Board had met and Task Forces
were being set up regarding children, people with learning disabilities and older people. Hilary Blumer said that
she has already met with Robin Hughes and Dorothy Lewis re the link between the Children's Task Force and Quality
Protects, and the need to address health inequalities and child poverty. Bernard Walker said that ADSS (NW) believed
that social services could and should take an active role on each of the Task Forces.
7.2 Care Trusts: Peter Hewitt asked about the current state of thinking on Care Trusts. Peter Rowe
said that the project leader was coming over to discuss this with the NHS Executive (NW) the next day, but Care
Trusts do represent more of a balanced mix of health and social care than PCT's. There appears to be clarity about
Ministerial intentions in relation to adult services, but less so with regard to children's services. Councillor
Strett said that Care Trusts needed to be based on proper partnership arrangements, and the Local Government Association
had expressed concern that Care Trusts would be firmly based within the NHS rather than new joint organisations.
8. Arrangements for future Meetings:
Councillor Morris thanked Professor Higgins and the other NHS and DH representatives for helping to move matters
forward so fruitfully at these meetings. Despite Professor Higgins' role ceasing, he would still value an opportunity
for a forum in which members' views could be expressed. It was agreed that Cllr Morris should write to Professor
Tinston to pursue the idea of continuing occasional meetings, and it was suggested that September might be a good
time for the next one. In the meantime, continuing officer representation at appropriate joint meetings was greatly
valued.
9. Any other Business:
There being no other business, Professor Higgins thanked all those present for their contributions, and declared
the meeting closed.
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