38,000 council workers facing a switch to NHS

TENS of thousands of council staff across Scotland will transfer to the NHS under a radical plan to look after the elderly which is being announced by ministers today.

The Scottish Government is planning to shift responsibility for delivering adult community care from local authorities to health boards within two years.

Organising home care or care home places for patients who require extra support after leaving hospital will fall to the NHS rather than social work under the shake-up.

The council will merely commission the services, and some 38,000 current local authority workers will deliver it within the health service.

Whether the core budget will be held by the council and used to buy the services from the NHS or whether the NHS will be given the money to cover costs such as salaries up front, is not yet clear.

The Scottish Government said financial and governance arrangements were to be considered in greater detail by its implementation group.

However, the rules of TUPE, which protect employees’ terms and conditions when they are transferred from one organisation to another, will apply to the staff affected.

The proposals are intended to create a smoother journey for the patient, reduce problems such as bed blocking where people are stuck in hospital waiting for a community care package to be arranged and save money.

The system, known as lead commissioning, is already being used in some parts of England and is due to be piloted in the Highlands by 2012.

Lord Sutherland, the architect of Scotland’s flagship free personal care deal for the elderly, has backed the plan.

He said: “Lead commissioning provides the best and quickest way of achieving an integrated care system, and I believe the Scottish Government’s approach is the right one. It avoids the need for new legislation and wholesale re-organisation, which means improvements can begin to be made straight away.

“The time for talking is over. It is now time just to get on with it.”

However, the move is likely to be controversial with unions and local authority bodies.

Breaking down the barrier between the NHS and social care has been discussed by other political parties. Scottish Labour has already proposed creating a national care service, which would merge the two into one organisation inside the NHS and would eliminate the postcode lottery which can exist around the levels of community support available free in different parts of Scotland.

Scotland’s aging population is one of the key drivers behind the change, with forecasts showing a 50% increase in the number of over-60s by 2033 and the number of people with dementia doubling in 25 years.

Shona Robison, minister for public health and sport, said: “The imperative is around older people’s services. Because of the demographic changes, doing more of the same and the status quo is just not an option.”

She said successive governments had tried to solve the problems created by handing the care of frail patients backwards and forwards between councils and the health service, with only partial success.

She continued: “Having a single point of access to care means it is easier for patients. Patients know where to go. It improves waiting times for [a care package] assessment. You are not waiting for the assessment to be passed from one part of the system to the other. There is less chopping and changing.”

According to Ms Robison, areas in England which have the system in place including Torbay have found it reduces waiting times for community care, shortens hospital stays and cuts the number of emergency admissions to hospital.

She said it made it easier to offer preventative help, intended to stop the frail suffering crises which put them back in hospital.