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UPDATE


INTERVIEW


PRACTICE


RESEARCH


POLICY


What will the new law mean?


The new Health and Social Care Act will have implications for social workers. Jon Glasby reads the runes.


N


ow that the new Health and Social Care Act has passed into law, social workers might be forgiven for looking on with


degree of bemusement. Debates surrounding the reforms have been acrimonious, with claim and counter-claim about what is actually intended and what will happen in practice. Until the dust has settled it will be hard to know what all the changes mean for social work – and it may take several years for the full implications to emerge. However, four things do seem more likely than others: 1. The main challenge facing the NHS is the need to respond to an ageing population and rising demand. This may mean rebalancing the current system away from a traditional focus on acute hospitals and trying to promote care closer to home for people with long-term conditions. Hospitals may prove too powerful for this to take place in a meaningful way, but, whatever happens, a close relationship between community health and social care services will be crucial.


2. Large-scale reorganisation often disrupts existing relationships, and can reduce morale and productivity for a signifi cant period afterwards. Both the NHS and social care are facing signifi cant fi nancial challenges and widespread structural


changes at the same time – and this is likely to make joint working harder in the short term.


3. With the development of clinical commissioning, the role of GPs will be much more prominent. In addition to trying to preserve joint arrangements that already work well, social care will have to fi nd ways of engaging with and developing relationships with GPs.


4. Although it’s not clear exactly who will be responsible for what, the Act’s new health and well-being boards could be a forum for senior leaders to come together to make sense of the changes, prioritise scarce resources and fi nd new ways of responding to need.


Crystal ball gazing is always dangerous, but the early signs are that recent policy could make joint working more important – although harder – and could make relationships with GPs even more important than before. However, the future system could also


prove very fragmented. Whether health and well-being boards will be able to act as the glue that holds health and social care partners together remains to be seen.


Jon Glasby is professor of health and social care and director of the Health Services Management Centre at the University of Birmingham


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