LGA CONFERENCE REPORT
ity, because 132 of us have been doing it for awhile, and doing our websites and been connected to that. But anyway, let’s take that money, it will be welcome.
“We absolutely need system leadership around health and wellbeing strategies and the overall spend on health and social care. I feel really strongly, as we go through this next phase of coterminosity, it’s crucial to get this right in the future. We must move away from patient pathways to the acute hospital as we work together.
“Andrew Lansley mentioned the three out- comes frameworks. I think it’s us locally who are joining up the three outcomes frameworks for the NHS, public health and social care.
“Operationally, we’ve got some excellent examples of integrated working across the country. We all hear about them all the time. But I think that there’s a fear at the moment that we will lose that work between PCT commissioners and local government, and what system will replace that, how will we get it embedded? So we need a very strong sense from Government that we should have Pathfi nders on joint commissioning as quickly as possible. We didn’t hear that today and I think we need to continue to push for that – and for the infrastructure for joint commissioning.
“But fi nally, the important point is what Andrew was saying about how we integrate at the level of the individual citizen. He said that it’s really important that we’re talking about designing the services around the person – customised health and social care plans. We’ve recently done an update on how many people have personal budgets in social care, and it’s still only 37%, and only a third of those have cash payments.
“So there’s a lot of opportunity for us to im- prove on that, a lot of opportunity for GPs to innovate around personal health plans, but learn from the journey that we’ve made in local government. We have been working in a mixed economy of care since the mid- 90s. We’ve made loads of benefi ts, but we also know that we can drive out too much money from the system. And the draft re- port from the Human Rights Commission last week was absolutely saying that, there wasn’t enough money in some of these re- ally important systems. Homecare was an example last week.”
Linda Thomas, deputy leader of Bolton Council, said: “I have to say at the outset, I’m a Labour politician, and we didn’t par- ticularly want this major restructuring of the health service – I think it has been a major distraction for many of you who have got lots of other hard decisions to make, and it’s certainly been the major distrac- tion for the community wellbeing board. Unfortunately, I feel we’re taking our eyes off the ball when it comes to actually talk- ing about integration of adult social care.
“I listened to Andrew Lansley talking about integration, health and social care, shared decision making, focusing outcomes and stronger local public health: who could ar- gue with that – they’re all laudable aims. It’s what’s behind that. It’s how we deliver it, who delivers it, the transparency of it, the accountability of it. I’m not quite sure that those are things that are completely in place for everybody to understand.
“We have been a joined-up voice across local government in asking for things that we feel that as local authorities we need to get in place. One of them was the cotermi- nosity. The other one was the commission- ing for all populations, because initially it
would have meant that doctors would have just been a consortium that would just have to pay for their people in their own practic- es. We’ve managed to win that argument.
“And we’ve demanded greater transparen- cy for consortia, and I notice that now there will be clinicians on the board as well as lay members. The only slight fl aw in it is that the clinicians will not be able to be within the boundaries of the area. So how do they go about understanding actual local needs – that might be a bit diffi cult.
“One thing we’ve been really worried about, and we’ve not nearly heard any answers to it, is about the fragmentation of children’s health services. Because what seems to be in the background at the moment is that lo- cal authorities will only be responsible for commissioning for ages 5-19, and 0-5 will still remain with Public Health England. We’re a bit concerned about that, we think that’s an artifi cial divide. We believe we could do that very ably, and I think behind the scenes, the message seems to be coming that they’re just not quite sure that they can trust us with that. My message is that you certainly can trust us – that is an area that we would be very good at commissioning.
“The area that I’m not quite certain about though is about health and wellbeing. My concern is that we will be holding public health money to deliver public health func- tions; I think the Prime Minister said he was stopping ringfencing, but that is actually go- ing to be ringfenced. We’ll have the adult so- cial care money, and I know that we’re going to be very willing to integrate money.
“The consortia, the doctors, will hold the lion’s share of the money and I do appreci- ate we’re going to have a lot of ‘discussions’, we’re going to need to decide our JSNAs (joint strategic needs assessments) togeth- er, we’re going to decide our health plans.
Health Secretary Andrew Lansley addressing the conference
“But I fear, where there are not good rela- tionships in towns and cities up and down this country – and I for one have a very good relationship with our GPs, I don’t en- visage a problem – but where there are not good relationships, I just worry that if there is not a compulsion there to actually put the money on the table, then maybe in one or two areas there would not be suffi cient money to do preventative work that we all know we need to do. I would say to Andrew, yes you’ve given us some teeth, but you haven’t given us a full set yet, and I would like it to be stronger in the legislation.”
© LG Group/Paul Thomas
FOR MORE INFORMATION Visit
www.local.gov.uk
national health executive Jul/Aug 11 | 11
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84