Health board breaks up key partnerships

Glasgow’s groundbreaking merger of social work and frontline healthcare has collapsed, sparking unprecedented strife between the nation’s largest health board and local authority.

In what could be the final blow in a power struggle over control of budgets, NHS Greater Glasgow and Clyde (GGC) voted yesterday to break up a network of community health care partnerships (CHCPs) and go it alone, a move council sources describe as being carried out in a fit of pique.

It follows the council’s decision not to commit £400 million to the CHCPs in a one-off move and instead contribute incrementally, despite having previously agreed to devolve its entire budget in April.

In a scathing report, the health board says the council’s chief executive George Black previously gave his unwavering commitment to the CHCPs.

It also effectively accuses the city council of lying over warnings from public-sector watchdogs over financing the network, stating, contrary to claims made in the authority’s executive committee, that “we are not aware that scrutiny bodies have framed expectations to the council which advise it not to proceed on the previously agreed basis”.

The council has accused the NHS of brinkmanship by attempting to force its hand by taking the “nuclear option” of winding the system up, adding that it will now take longer to bring the CHCP system to closure than it would have taken for the council to makes its incremental contribution to match £500m from the NHS.

The role of senior personnel on both sides has also been said to be a contributing factor.

The health board’s performance review group has now recommended to the full board to prepare its own plans, while the council has accused NHS GGC of unilaterally bringing this arrangement to an end.

The NHS report states: “The NHS board has no option but to consider how it can move to establish stable and viable organisational arrangements to replace the CHCPs.

“At a time when public services will be under unprecedented financial pressure, failing to deliver the change to move to fully integrated and devolved arrangements loses the opportunity to increase efficiency and, therefore, to protect the most vulnerable service users.”

CHCPs were set up in 2006 to deliver community-based health and social care services provided by health visitors, district nurses, social workers, physiotherapists and dieticians. They are also responsible for local learning disability, mental health and addiction services and were established in part to save hundreds of millions of pounds.

They have often been cited as a model for the rest of Scotland, including in the recent report by Sir John Arbuthnott on how the public purse could save millions of pounds by closer working.

A council spokesman said: “We are completely committed to joint working with the NHS and on CHCPs in particular. We are committed to devolving budgets to the CHCPs, albeit not as immediately as the NHS would like it.

“Therefore it is a matter of great regret that NHS GGC has decided to unilaterally bring this arrangement to an end.”

NHS GGC chairman Andrew Robertson said: “It is disappointing that our shared vision for a model of fully integrated health and social care services for the city will not now be achieved.

“We were also concerned that devolution to CHCPs is characterised as creating financial risks for the council. CHCPs have single management teams. These teams manage over £500m of NHS resources and have consistently delivered financial breakeven and NHS savings targets.”