A devolution deal for Cornwall, including greater integration and control over health and care spending, is expected to be announced by the chancellor next week, HSJ has learned.
The ambition is that by the end of the decade the area will have developed options for the management of a £2bn pooled budget combining health, welfare and social care spending.
The full details of the deal are still to be finalised, but chancellor George Osborne is expected to make reference to it when he delivers the emergency budget on Wednesday, according to several senior figures involved in discussions.
It is expected to mean Cornwall developing a similar approach to that proposed for Greater Manchester earlier this year. It would be the first area outside of a major city to win a devolution deal.
In Manchester it is proposed that health and care commissioning budgets would be integrated, and pooled with the area’s share of NHS England’s primary and specialised services budgets. However, HSJ understands that, unlike in Manchester, NHS England at present has no intention of delegating its specialised services budget to Cornwall.
Senior sources aware of the discussions in Cornwall, who spoke to HSJ and its sister title Local Government Chronicle, said the devolution deal was likely to involve integrated commissioning of health and social care by Kernow Clinical Commissioning Group and Cornwall Council.
Under Cornwall’s plans by 2020 health and social care budgets will have been pooled in full and the area will be looking at options to combine it with welfare into a single pot worth about £2bn, the cabinet paper said.
Joint commissioning of health and social care would start on 1 April 2016 with the domiciliary care and care at home budget, and the budget for children’s community services, with Kernow CCG leading on the former and the council on the latter, under these local proposals.
The devolution plans, and the integration of commissioning in particular, are seen as complementary to existing proposals to achieve greater integration between health providers in the county, HSJ understands.
Acute provider Royal Cornwall Hospitals Trust and Cornwall Partnership Foundation Trust, which delivers mental health services, began merger talks earlier this year.
In addition, a social enterprise that provides community services across Cornwall and oversees the county’s 14 community hospitals has said that it will not seek an extension to its current contract because of longstanding financial difficulties.
In April HSJ revealed officials from the Treasury, the Department for Work and Pensions and the Department for Communities and Local Government were working with Cornwall to examine the potential savings from bringing together spending on health, social care and some welfare payments.
It is understood the devolution of transport powers, including the re-regulation of buses, are under serious discussion as well as health. It is not thought Cornwall will have to adopt a directly elected mayor, unlike Greater Manchester.
Wednesday’s expected announcement will follow proposals being published earlier this year for the devolution and pooling of health and social care budgets worth £6bn to the Greater Manchester Combined Authority. However, while Greater Manchester has 10 metropolitan authorities and 12 CCGs, Cornwall has just one unitary council and one CCG.
John Pollard, leader of Cornwall Council, refused to comment on what powers could be included in any deal, but told LGC: “For some weeks and months we have been preparing a ‘case for Cornwall’ which are the things we think Cornwall could benefit from having. We have been discussing those with officials and civil servants and those discussions continue.”