‘Truly integrated’ service model scrapped after failure to improve care

In June 2017, Wirral Council outsourced the bulk of its social care services to Wirral Community Health Care Foundation Trust, transferring around 240 staff in the process. The contract had an annual cost of £10m. 

The staff transferred included those who commission social care provision in the borough, as well as assessment and reablement workers. The trust also had delegated responsibility over the wider social care budget.

WCHC had previously stated that Wirral was one of the few places in the country to have made “significant progress towards truly integrated health and care provision”.

However, the council has now decided to bring the service back in house.

At a council meeting on 11 January, Graham Hodkinson, the director of adult social care, said the council’s priorities were not always reflected in how the services were being run.

He also noted that a new inspection regime for adult social care due to be launched by the Care Quality Commission would be looking for “a golden thread between council policies and delivery on the front line”. He suggested it could be seen as a weakness if there was a lack of cross working with other council departments, and if staff under the contract were not aware of the council’s overall priorities.

A review of the arrangement last year concluded: “Whilst services have remained safe and of a good quality the review has not evidenced significant and sustained improvement of service outcomes for people through delivering under the current delegated arrangements.”

The review also noted the “negative trajectory” of a key performance indicator which measures the proportion of service users having an annual review. This risked their needs increasing because of the lack of early intervention, and therefore posing a greater financial burden on the council.

The local authority has proposed a one-year extension to the current contract, until September 2024, to ensure time to plan the transition. But Mr Hodkinson told the January meeting that WCHC was unwilling to agree this, due to concerns that a “protracted transfer” would create uncertainty and destabilise the workforce. There was also a concern over the “integrity of the trust’s relationship with the council”.

He said the trust had proposed to end the contract in April this year, or for the council to consider a five-year extension. The two organisations are now in discussions about agreeing a compromise, which could be for the contract to run until the current end date of September 2023.

In a joint statement, the trust and council said: “WCHC has respected the council’s wishes and we are working to ensure the timely and safe transfer of the contract…

“Each organisation has remained professional and focused, establishing a project team to manage a smooth contract transfer… We continue to work closely together to maintain what we have collectively achieved over the last six years.”