OVER THE WALL

Chief social services inspector Denise Platt is making an irresistible offer to NHS and local authority staff drowning in documents: they will no longer have a statutory responsibility to produce a community care plan (CCP) under a proposal for consultation until 4 November.

The rationale for removing the obligation is eminently reasonable: partnership working has developed greatly with health improvement programmes and joint investment plans. In fact the CCPs' death knell sounded when guidance on preparing joint investment programmes told councils they were free to produce a CCP as a stand-alone document or demonstrate that their JIPs and HImPs had met the statutory requirement.

CCPs will have few mourners, but they have occupied an honourable and significant niche in post-war health and social care policy. Introduced in 1990 by the Thatcher administration, CCPs stood as a solitary beacon of state planning amid a storm of competition, privatisation and market principles. Essentially there were four requirements: to publish a plan; to make it readily understandable; to consult with specified local stakeholders; and to ensure plans were joint with, or complementary to, those of health authorities.HImPs, JIPs and community plans have been able to build on these foundations.

The first-round plans in 1992 built on weak foundations.

Highly critical reports through the 1980s had exposed the deficiencies of social and health service planning in the 1960s-70s.

The last - the Griffiths report of 1988 - referred to 'only limited evidence of systematic planning' in social services departments, and described the record of interagency planning as 'the discredited refuge of imploring collaboration and exhorting action'. Griffiths regarded the establishment of a credible planning system as vital, and proposed that local authority funding should be conditional on an annual CCP showing evidence of joint planning.

If the CCP experience has not been positive everywhere, much blame lies with the rejection of this recommendation, and the feeling among Conservative politicians that planning was somehow Old Labour.

Former health secretary Virginia Bottomley and her successors never got much beyond the imploring and exhorting that Griffiths so scorned.

Detailed practice guidance on every other major aspect of the NHS and community care reforms was plentiful, but nothing was produced for CCPs until 1995, and nothing has been produced since.

Analyses of several rounds of CCPs by the Nuffield Institute for Health identified problems and achievements. The main initial problem was the multiplicity of audiences CCPs were expected to address.

Subsequently, long-term care charters made it easier to concentrate on CCPs as purely commissioning documents.

Moreover, many CCPs were too inclined to look back, rather than outline strategies for action.

In relation to the NHS, initial policy guidance referred to plans being joint 'wherever possible'. As a minimum, they were expected to be complementary. Nuffield showed a significant shift in this respect, with the proportion of 'joint' plans rising from 64 per cent in 1992-93 to 95 per cent in 1995-96. Evidence showed increased involvement of users, carers, providers and others in producing the plans.You might think strategic joint planning between the NHS and local government is now sufficiently established for CCPs to be abolished, but it is important that these close links with service delivery are retained.

The Department of Health acknowledges this when it concedes, 'there may be some smaller groups of service users whose needs are not accounted for'when CCPs go.

Presumably this refers to those not currently part of a JIP requirement. The main group is adults of working age with a physical disability, other than those covered by the welfare-towork JIP. Since the review of the DoH's shape and direction the chief nursing officer has been responsible for them - so there is already concern about reintroducing a medical or nursing model of care.

And what of children and young people? There seems to be no parallel ending of the obligation to produce multiagency children's services plans led by local authorities, but there is a danger that these will become semi-detached from the NHS's broader processes.

It would be unfortunate not to pay modest tribute to CCPs' contribution to inter-agency planning. At a minimum they symbolised the view that even a market-driven system needed planning - at best they constituted the very progenitor of the more effective approaches we expect today.