Published: 18/08/2005, Volume II5, No. 5969 Page 9
The Department of Health is considering imposing a legal duty on primary care trusts and councils' social services departments to work together to improve adult care.
The NHS Confederation, the Association of Directors of Social Services and other members of an inter-agency group working with the DoH on the implementation of March's social care green paper are urging the government to use the forthcoming white paper on healthcare outside hospitals to impose the duty.
This week, national director for social care Kathryn Hudson confirmed that the DoH was 'looking at their ideas' on the issue, but stressed 'we will not be committing ourselves to anything yet'.
John Dixon, chair of the Association of Directors of Social Services disability committee, said: 'There was support on the green paper inter-agency group for a duty to cooperate. This will undoubtedly help, but anyone who believes it will be a magic wand is deluded.' NHS Confederation policy manager Jo Webber said: 'If you go out to PCT-land, people say care packages for long-term conditions are not delivered by primary or social care, but in an integrated way. I would like a policy that will help deliver that.' The idea of a duty was originally raised as an option in the social care green paper, which also floated the idea of older people's trusts, 'virtual' bodies based on the children's trust model. Managers from adult social services and primary care trusts would meet to discuss how to divide up pooled budgets. Representatives of other council services affecting healthcare - such as housing, leisure and transport - could also be present. The white paper, due to be published by the end of this year, will merge the social green paper with new policies in primary care.
Mr Dixon said a duty to co-operate would prompt many areas to establish children's trust-style arrangements. 'Many people think children's trusts are formal entities - in fact they are virtual, ' he said.
'They are partnership groups which pool governance, rather than constructing new organisations.' Housing provider Anchor Trust chief executive John Belcher said he hoped PCTs would work more closely with council housing departments and housing associations: 'If people live in poor accommodation, you can throw money at them but they are still likely to end up back in hospital. That is not economic in the long run.' But NHS Alliance chair Dr Michael Dixon said: 'We need to change the culture at the front line, not [have] more bureaucracy and legislation.
'Looking at structures is looking at the wrong end of things. It is far more important to get front-line commitment between social services and healthcare commissioners.' National director for older people's services Professor Ian Philp said delivery of the public health white paper should promote integration between health and social care, and 'go beyond the work that health provides alone'.
He said the NHS should work with local education and housing departments, while the DoH would work with the Office of the Deputy Prime Minister and the Department for Culture, Media and Sport.