Inter-agency partnerships to tackle winter pressures will be 'lopsided' unless the government plans a long-term cash injection for social services, NHS Confederation chief executive Stephen Thornton warned last week.

Speaking at a conference on winter pressures, he said the government's comprehensive spending review had been 'relatively generous' to the health service.

'Our social services colleagues need the same treatment, otherwise the partnership will always be lopsided,' he said.

A theme of the London conference was that social services would have a key role to play in relieving pressure on acute services this winter.

But Mr Thornton argued that this 'whole-system approach' would only work if both health and social services could depend on 'sustainable long-term investment' from the government.

Junior health minister Baroness Hayman said that 'good, flexible working relationships between health and social services' were vital for ensuring 'people are cared for in the most appropriate setting'.

However, she reinforced the message that the health service would be expected to deal with winter pressures while getting waiting lists down.

'Waiting-list targets, like emergency pressures, are part of a comprehensive approach to providing high-quality care to all patients,' she said.

Mr Thornton responded by saying he was 'disappointed' that managers had been given little guidance on how trusts should tackle emergency pressures while meeting waiting-list targets.

'One of the main disappointments today was the message to do what we are currently doing but better,' he said.

However, he welcomed Baroness Hayman's comments that patients had a responsibility to limit unnecessary admissions.

'We need to replace the 'me' culture with an 'us' culture,' she told the conference.

'We have to look at schemes like NHS Direct that actually make sure patients have the information about which bits of the

service, if any, they need to access.'

Hampshire county council director of social services Terry Butler called for a more even distribution of winter pressures cash to social services.

He said that there were 'wide variations' in the amounts received by departments last year, ranging from 5 to 70 per cent of the money handed out to health authorities.

'It is difficult to believe that such differences could be explained by differences in health and social care needs,' he said.

Mr Thornton said staffing had emerged as a key issue during the one-day conference. 'This time last year we needed money - but this year we face a much more intractable problem - staffing.'