DH advocacy of integration ‘not credible’

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The Department of Health is rarely a “credible advocate” for the integration of health and social care services because its policies are often contradictory, say senior NHS managers with dual local authority roles.

The Putting Our Heads Together: what makes senior joint posts work? report, published today by the PCT Network, says the public sector spending squeeze combined with the increasing long term condition burden means many PCTs and local authorities are “beginning to look afresh at how working together might be a solution”.

A number of interviewees feel that the health and social care branches of the DH currently do not communicate or coordinate effectively

The network interviewed eight senior managers who hold, or have previously held, joint positions across PCTs and local authorities about their experiences. They said that while a top down approach to joined up services was “not very fruitful” there was a lot more the DH could do to champion integrated working more effectively.

“Work should begin close to home, with the DH seeking to understand what it aims to promote by bringing its own health and social care functions much closer together,” the report says.

“A number of interviewees feel that the health and social care branches of the DH currently do not communicate or coordinate effectively, evidenced by the frequent release of policies that, viewed from the combined perspective of a joint post, are contradictory,” it says.

Interviewees “consistently referenced” the transforming community services programme as an example of this, as it “creates an imbalance in the functions and scope of councils compared to PCTs, constructs a new organisational boundary and makes integrating services all the more difficult”.

The report says: “Such divisions mean the DH is often not seen as a credible advocate for integration as it fails to set an example with which it can effectively challenge local organisations to do things differently.”

PCT Network director David Stout said: “The feedback we received shows that while there is enthusiasm for more joined up services, many local leaders are of the opinion that there needs to be a central rethink about how integrated care is promoted.”