Counties should get health devolution, says report

A new report from the county all party parliamentary group voiced alarm at a “devolution divide” opening up between counties and urban areas after the Greater Manchester Combined Authority was last week promised control of the area’s £6bn NHS budget.

Counties are concerned that urban areas have consistently gained devolved powers over transport and economic development faster than they have and are worried that the same will happen in health, hampering integration with social care.

The report, The State of Care in Counties, said 77 per cent of counties felt the financial pressures from adult social care were either “severe” or “critical”, and only 23 per cent felt these were manageable. Counties gained only £496 per head from the older persons’ relative needs formula, against £1,957 in inner London.

The report said the impact of social care capacity on the NHS was demonstrated by the fact delayed hospital discharge rates were 43 per cent higher in counties.

County councils should be able to negotiate health and social care devolution deals as part of a wider decentralisation of NHS England, the group proposed.

Health and wellbeing boards should gain powers to hold programmes for the integration of health and social care to account and to drive progress locally.

The report also urged the next government to examine the sustainability of adult social care as part of the 2015 spending review, including allocation formulae.

County Councils Network care spokesman, Kent County Council leader Paul Carter, said: “Giving counties more devolved control and influence over their local health and social care services is vital if we are to meet the growing pressures on our services. 

“Counties have substantially more older residents, complex care economies, but receive significantly less spending per head than metropolitan and city authorities – a successful integration process must take account of these challenges,” he added.