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SOCIAL SERVICES NORTH WEST (NWASSA)
MEETING ON 15 SEPTEMBER 2000 AT WIGAN
REPORT OF THE CO-ORDINATOR
WORKING WITH THE NATIONAL HEALTH SERVICE
1. Matter for Consideration:
To report developments in relation to the proposals of the NHS Confederation concerning the commissioning of
social care for older people; the meeting between Social Services North West and the Regional Chair of the NHS
Executive and the publication of the NHS Plan.
2. Introduction:
Members will recall the progress reported at the last meeting in building relations between Social Services
North West and the regional offices of the NHS Executive and the Social Services Inspectorate Social Care Group,
which had reached the stage of a meeting being fixed for 10 July. Before this could take place, the NHS Confederation
published (without consultation with local government interests) its controversial proposal that responsibility
for the commissioning of social care for older people should pass to the NHS. Shortly following the regional meeting,
the Government published its comprehensive plans for investment in and reform of the NHS. This report and its appendices
describe the part played by Social Services North West in each of these developments.
3. Information:
3.1 The NHS Confederation's proposals to reform the commissioning of social care for older people were published
shortly before the last meeting, and excited great concern amongst members and officers. It was decided at the
meeting that a high profile response was required, because it was considered fundamentally misguided to see organisational
tinkering as the answer to better working relationships between the health and social care services. It was agreed
to write not only to the Secretary of State Alan Milburn, but also to the 62 MPs serving the area of Social Services
North West member authorities, to enlist their support. A copy of the letter to the Secretary of State is attached
at Appendix 1. In this, the Chair, Councillor Cliff Morris made plain this organisation's commitment to partnership
working with the NHS to ensure seamless services to those who depend upon them. It was felt however that shuffling
organisational boundaries would be more likely to impede the development of true partnership working than to encourage
it. It was also considered important to secure maximum general publicity for the position of Social Services North
West. As reported separately, a press release was produced, a comprehensive list of media across the region compiled,
and personal contact made with key media at national, regional and sub-regional level. Efforts to secure the interest
of regional television, with filming opportunities in two member authorities, were unsuccessful on this occasion
but a substantial article appeared in the Manchester Evening News and a shorter one in the 'trade journal' Community
Care. The worst fears excited by the NHS Confederation proposal were not confirmed when the NHS Plan was published,
and it would be good to think that our campaigning, along with that of many others, helped to forestall proposals
which would have been very problematic to implement.
3.2 The meeting with the Regional Chair of the NHS, Professor Joan Higgins, and Department of Health officials
from the North West Regional Office of the NHS and the Social Care Group (North) of the Social Services Inspectorate,
was held in a very constructive atmosphere, with both sides stressing the need for a partnership approach in health
and social care. The Chair of the North West Branch of ADSS, Ken Foote of Blackburn, accompanied the Social Services
North West delegation. The minutes of that meeting are attached as Appendix 2. Most importantly they were sent
out to the Chairs and Chief Executives of all local NHS organisations in the region as well as to all Lead Members
and Directors, under cover of a joint letter from Professor Higgins and our Chair Councillor Cliff Morris. Action
is continuing to address the detailed issues discussed, and it is hoped that this visible unity of purpose at regional
level will strengthen the message of partnership locally between health and social care, if ever this should appear
to be wearing thin.
3.3 The publication of the NHS Plan at the end of July was welcome, particularly in the context of the substantial
extra resources committed to both the NHS and social care services. Copies of the Executive Summary, of chapter
7 - Changes between health and social services and of Chapter 15 - Dignity, security and independence in old age,
are attached at Appendix 3. There are also welcome proposals for a new role for local government in Chapter 10:
Scrutiny of the NHS
10.25 Local authorities are an important democratically-elected tier of
government. As they modernise they will become more effective channels for the views of local people.
10.26 As a result of this Plan local government will be given the power to scrutinise the NHS locally. Chief executives of NHS organisations will be required to attend the main local authority scrutiny all-party committee at least twice annually if requested.
10.27 The power to refer major planned changes in local NHS services to the Secretary of State will transfer from unelected community health councils to the all-party scrutiny committees of elected local authorities. The council scrutiny committees - which must meet in public - will be able to refer contested major service reconfigurations to the new Independent Reconfiguration Panel (see paragraph 6.50). Clear criteria will be set out on the definition of a major service change that can appropriately be referred for consideration nationally.
3.4 Overall, there is a great deal to welcome in the NHS Plan. There will be a statutory requirement for health
and social services organisations to co-operate, but no national prescription or further legislation for a nationwide
shift of the boundaries between health and social services. This is a welcome recognition that better care for
individuals and families will come when those at all levels in all relevant organisations work together to ensure
this. It is to be hoped that the Plan's preoccupation with the health/social care interface will not obscure the
important links that social services, rooted in local government, makes to other local services and community resources,
thus enabling a much wider partnership to promote quality of life.
4. Conclusion
There are many aspects of the NHS Plan which will require further study and careful thought and planning as
to how they are implemented locally and regionally. Social Services North West has established itself as a significant
player at regional level and is ready to support member authorities in whatever ways will be helpful in meeting
the Government's expectations of the health and social care system. Members are invited to identify what particular
roles the organisation might usefully play between now and early 2001, when we next meet with the Regional Chair
of the NHS.
5. Recommendation:
5.1 That the report be noted
5.2 That appropriate tasks for Social Services North West to undertake during the next six months in relation to
the NHS Plan be identified.
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