DH revises guidance on joint health and social care arrangements
The Department of Health (DH) has revised guidance to protect integrated health and social care arrangements only days after it was published, but there are fears it has not gone far enough.
Last week the DH added a section to the guidance, calling on strategic health authorities, primary care trust clusters, PCTs and councils to “work together to identify how to maintain joint working arrangements” with the understanding that temporary arrangements should not lead to the dismantling of effective joint appointments.
It also demanded the new clusters’ boards take account of Care Trust and Care Trust Plus arrangements that involve significant integration with local social care departments.
The revised guidance said: “The single executive team within a cluster where there is one or more Care Trust must contain an individual who has experience of the health-related functions of the local authority or authorities covered by the Care Trust.”
The Local Government Association has lobbied for areas with advanced health and social care integration to be exempt from joining clusters ahead of the 2013 switch to GP commissioning to avoid damaging existing arrangements. However, the DH has resisted the calls.
Graham Burgess, chief executive of Blackburn with Darwen BC and Care Trust Plus, said the additional guidance recognised there were further issues to be resolved but would not safeguard joint arrangements.
“It shows the DH realises that Care Trust Pluses have a distinct character, but it doesn’t assist matters greatly,” he said. “There needs to be some more discussion between the LGA and DH about this.”
Mr Burgess said there was a contradiction between the government’s commitment to keep Care Trusts post-2013 – maintaining joint appointments – but still subject them to clustering.
Mr Burgess believes trusts with joint appointments should be allowed to co-operate with sub-regional clusters without having to surrender their autonomy.