Two star speakers have agreed to share the platform at the conference on Modernising Health and Social Care.  Hazel Blears, Parliamentary Under Secretary at the Department of Health and MP for Salford has agreed to address the conference on Involving Patients and the Public in Healthcare, and Peter Garland, Director of Health and Social Care – North in the Department of Health will speak on Modernising the NHS. 

As is customary, the keynote speeches will be supported by examples of good practice from within the region.  The Minister's session will be followed by a presentation 'Involving Salford People', led by Councillor Peter Connor, Lead Member for Social Services on Salford City Council and Eileen Fairhurst, Chair of Salford Primary Care Trust.  Following Peter Garland's contribution, Anita Marsland, Director of Knowsley Social Services will lead a presentation entitled "The Knowsley Way - An Alternative Means of Integration". 

Two dozen members and officers had travelled to London to put their points face to face, and a similar number of North West MPs turned up in person to hear what we had to say.  Councillor Ken Keith (Knowsley), Deputy Chair of Social Services North West who chaired the meeting, said "I was very pleased with our turnout, and with the way our members expressed themselves.  The MPs did take our message on board and I feel it was very worthwhile.  We were most grateful to David Crausby MP for fixing it"

A further survey in January confirmed that personal social services are under considerable pressure, as they undertake a massive programme of change, aimed at providing appropriate cost effective services which meet the real needs of clients and the Government’s modernising agenda.  The resulting pressure manifests itself in the form of inadequate resources both financial and human.

There have been various causes of the resources shortfall, including the demographic growth of members of vulnerable groups, better identification of need, the pressure to meet higher expectations from clients, market pressures and the development of new preventative services, whilst maintaining existing services.  Some additional funding has been made available but much of this is either short term or has been ring-fenced for new developments, making longer term planning very difficult. 

A particular pattern is that responsibilities being transferred from central government tend to be under-funded (for example the transfer of responsibilities for residents with Preserved Rights to local authorities), whilst when responsibilities are transferred from local government, an excessive amount of funding is withdrawn (eg the transfer from local authorities of inspection to the National Care Standards Commission). 

Building capacity, avoidance of delayed discharges from hospitals and learning disability services were all cited as significant pressure points by many respondents from SSNW member authorities.

The local media responded positively.  The Manchester Evening News quoted Councillor Cliff Morris from Bolton, Chair of Social Services North West: “The government is giving social services departments new things to do and not enough money to do them. Resources will not be enough to match the increased pressure.”

An editorial in the Oldham Chronicle said: “Whilst the NHS remains at the top of the Government's agenda and benefits from a big increase in its budget this year, social services have been left grossly underfunded.  The trouble is that health, hospitals, operations and life-and-death are all more emotive than the quietly efficient ethos of care that permeates social services.

The Warrington Guardian reported Cllr Colin Froggatt: "We have been given new responsibilities and duties by the Government - but we have not been given the money to pay for them.

Three local radio stations also carried interviews.

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“I felt it was a very civilised discussion," said Councillor John O’Neill (Wigan).  "They were aware of our concerns but it reinforced the message.”  Councillor Peter Connor (Salford) said: “This is the best feeling I’ve had from any delegation I’ve been on to London.  It shows that this organisation is now a formidable group.”  Closing the discussion on this item, Cllr Cliff Morris (Bolton) Chair of Social Services North West said: “Clearly an excellent start has been made.  It appears from what the MPs told us that the Secretary of State is indeed listening.  But this is not the end of the road, and the pressure will continue.”

Some of the points made at Westminster were:

Cllr Frank Roderick highlighted the issue of local authority statutory duties in relation to children’s services, which were problematic given the lack of adequate funding to meet increasing need and higher costs of provision.  Since Government funding had not addressed this, this was having an impact on Council tax levels. 

Cllr Linda Robinson agreed and cited the example of Rochdale’s difficulties with funding for children with learning disabilities.  Staff recruitment was also an increasing problem.

Ian Stewart MP said that these issues had been addressed at a meeting of the SIGOMA group with Stephen Byers last night, and the whole basis of local government funding was being re-examined. David Crausby MP said that in his role as Chair of the North West MP’s, he will put the matter on the agenda of their next meeting and continue pressing Ministers.

Cllr John Taylor said that there was a need for more joined up services for children, as was increasingly emerging for older people, and but the discrepancy in funding increases between the NHS and local authority social services was the major obstacle.

Cllr Chris Holtom spoke as a newly appointed non-executive member of a Primary Care Trust, which was expecting a funding increase of almost 10% - greatly in excess of any increase for social services.

Cllr Alan Massey spoke on community care issues and the limitations of short-term funding, for example the Building Capacity grant.  Care home owners were pressing for fee increases because of staffing costs and the requirements of the National Care Standards Commission.  He said that the health inequalities programme cannot be delivered nationally unless it is delivered in the North West. 

Nigel Evans MP said that guidance was needed about the true costs of providing services and that regular briefings would be helpful to then deal with the problem more effectively. 

Cllr John O’Neill talked of the problems arising from the increasing number of earmarked Government grants.

George Howarth MP urged caution on the grant system: there is a case for earmarked funding in certain situations.

Cllr Peter Connor said that Salford had been recognised as one of the best authorities, but was spending substantially over SSA on social services.  They had offered good standards but were now having to tighten criteria, at a time when they could do with placing more children in need and the demand for residential care is substantial.

Andy Burnham MP said that he felt that Ministers were not sufficiently aware of the real impact of financial settlements and that eligibility criteria are excluding too many people.

Cllr Ken Keith said that local authorities did recognise the increase in funding, and we are going out of our way to work as closely as possible with health colleagues, but the NHS can’t be revitalised without enough money for social care support.

Joan Humble MP, as Chair of the all-party group on social services, said that much was already being done to raise the profile of social services.  She cited the positive developments such as the General Social Care Council and the National Care Standards Commission, which would both come into being in April.  Social services will be able to argue that it has sorted itself out and has a convincing case for more money. The introduction of the SSA formula removed a lot of indicators of social need, and we need to look more closely at the needs of local communities and get the money out there.  She believed it would be recognised in the forthcoming Comprehensive Spending Review that there has been a huge increase in demand for services.

Helen Southworth MP said that SSNW was pushing at an open door: the Government has given consistent resources and messages of support; social services needs to get its message across strongly and clearly to work closely together with other services.

David Crausby MP thanked the SSNW representatives for coming to London and for a valuable meeting.  He and other MP’s appreciate that there must be serious problems to trigger such representations. 

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The report on Children’s Services described a recent seminar for Assistant Directors (Children and Families) at the Lowry, Salford, addressed by the Children's Tsar Professor Al Aynsley-Green.  The event had three key aims:

• To create a regional vision for children’s services
• To consider performance issues and specifically how authorities can work together better, using available performance information
• To explore opportunities for regional and sub-regional collaboration

An Action Plan has been generated, covering:

Commissioning: a group of Assistant Directors will be established who will develop a model for the region: this will enable real progress to be achieved in terms of collaboration. 

Development Path for Children’s Services: Anita Marsland, Director of Social Services Knowsley, will take the lead in exploring the various models being developed regionally and nationally. It will address best practice in terms of outcomes for children, and the work will be done in partnership with other agencies such as Health and Education.

Child Protection: There will be a review of the role of the Child Protection Co-ordinators Group, an event for Area Child Protection Committee Chairs and the impact of the Climbie enquiry will be addressed.

Human Resources: The regional group is in the process of revitalising this area of work and a half day event is proposed to consider recruitment and retention issues regionally.  There is a serious shortage of qualified children’s social workers nationally.

Working with the NHS

Another report covered various aspects of our interface with the National Health Service.  It was agreed to make a response to the Government's consultation document on Local Authority Health Overview and Scrutiny, which is another major component of the new relationships being constructed between the modernised NHS and modernised local government.  In local government, these proposals have been widely welcomed as a logical development within local authorities’ new discretionary powers “to promote or improve the economic, social or environmental well-being” of their area.  In NHS circles however, they are not yet fully understood and accepted.  Local authorities must therefore approach their new tasks with care and sensitivity and in a spirit of partnership with the other local players, particularly the NHS.  Social Services North West will reply to the consultation.

The DH paper Shifting the Balance of Power: The Next Steps sets out how the new NHS will give greater authority and decision making power to patients and frontline staff, underpinned by changes in organisational roles and relationships.  Social Services North West will find much to welcome in this approach, and it is important that we engage positively with the new structures as they emerge, and show our readiness to address the issues of principle and behavioural change as well as the day-to-day practicalities.  Members decided they would like a meeting arranged with the Chairs and Chief Executives of the three Strategic Health Authorities in the region. 

Learning disability

On learning disability, two proposals were agreed for contributions to the work of the Regional Task Force on Valuing People: a website for non-professionals and a conference later in the year.

SSNW Budget

Members also appraised the budgetary position of SSNW and set the subscription rates for next year with an inflation rate of 2.5%. 

As always, the full set of papers from the meeting, and much more, can be accessed on our website

Read more on www.ssnw.org.uk!