PAPER B2

 

Committee :   SOCIAL SERVICES, HOUSING AND BENEFITS SELECT COMMITTEE

 

 Date :             4  SEPTEMBER 2002

 

Title :               LEAD COMMISSIONING PROPOSALS FOR HEALTH AND SOCIAL CARE SERVICES FOR ADULTS

 

                        REPORT OF THE STRATEGIC DIRECTOR OF SOCIAL SERVICES AND HOUSING

 

 

 


SUMMARY

 

This report sets out the proposals for the Lead Commissioning arrangements for Health and Social Care for adults. The results of the consultation are included which gives the scheme a strong endorsement. The new structure is set out in Appendix 1.

 The paper includes a timetable, which would mean the new structure would be in place by January 2003 (see Appendix 2).

 

BACKGROUND

 

The long history of partnership between Social Services and Health has lead to closer working relationships between both parties. The joint Registration and Inspection Unit and the joint Occupational Therapy Team were 2 early examples. In April 2001, the Primary Care Trust (PCT) became lead commissioner for Health and Social Care mental health services and Social Services became the lead commissioner for Learning Disability.

 

In the Health Act (1999) and the Social Care and Health Act (2001), the Government envisages closer working still, up to full organisational  integration .

 

PROPOSAL

 

The senior managers in the Directorate have worked with their counterparts in the PCT to produce a set of proposals which will lead to joint commissioning for all adult services. Under these arrangements, there will be two Heads of Health and Social Care Commissioning Posts (one for services for adults under 65 and one for adults over 65). They will be supported in their work by a new post of Senior Commissioning Manager. They will report to and be held accountable for their performance by an Officer Management Board jointly chaired by the Strategic Director of Social Services and Housing and the PCT Chief Executive. The Management Board will agree their work programme and will meet every 2 months to review progress.

 

All the care management and assessment staff, together with those in Direct Services staff , will remain under the operational control of Social Services. It is proposed to create a new post Head of Operations to manage these staff groups. This post will report to the Strategic Director.

 

There are no current proposals to merge further, the commissioning budgets. However, an officer group is studying the implications of such a proposal, which is generally regarded as a sensible development. This may form the basis of a future report. There would have to be adequate safeguards to protect the interests of the Council and the PCT.


The Council and the PCT would retain ultimate responsibility for the standard of Social Care and Health Care respectively for the Isle of Wight. The Heads of Commissioning would attend council committee meetings and PCT Board meetings as required.

 

There are no proposals to merge the commissioning arrangements for Children’s Services. Although it will be part of the remit of the Management Board, the Health and Social Care functions regarding Children’s Services will continue to be discharged by 2 separate senior officers. However, good practice would be to include a representative from Education Services on the Management Board. This would ensure the 3 main agencies involved in carrying for children in need are involved in commissioning future services.

 

The long-term future of Children’s Services is unclear at present. The Government’s response to the Laming enquiry into Victoria Climbie’s death is expected in the late autumn. This could have profound implications for the future shape of these services. These proposals do not commit either the PCT or the Council to a new legal body. A Care Trust is not an inevitable consequence of these proposals. However, if adopted these proposals should lead to less duplication of effort and better use of resources. It could remove the perverse incentives which currently exist and will make it easier to plan and deliver services which meet the needs of people on the Isle of Wight.

 

CONSULTATION ARRANGEMENTS

 

A copy of the report, which went to Executive Committee and the PCT Board in July, was sent to key stakeholders. The Chief Executive of the PCT and the Strategic Director were also present at a public meeting at the Riverside in Newport in August. There is a broad consensus in favour of the proposals. They are seen as positive and helpful; offering the chance to reduce duplication. As one group said: “This is a chance not to be missed”. However, both agencies were asked to make sure they learnt the lessons from merging mental health services. We were also asked to see if we could merge the complaints processes at some stage in the future. We were also asked to ensure the proposal didn’t lead to a loss of funds to the voluntary sector. There was support for joint budgets, but we were asked to be clear about how overspends are dealt with. Letters of support were also received from the Chair of the Nursing Home Owners Association, the Chair of the Learning Disabilities Parent/Carer Forum and from the Chief Executive of the NHS Trust.

 

FINANCIAL IMPLICATIONS

 

This proposal will mean commissioning up to £18m. of services for adults in collaboration with the PCT each year. The ultimate responsibility for ensuring the funds are spent wisely, prudently and in accordance with the assessed needs of residents rests with the Strategic Director. However, by agreeing to spend this money in conjunction with the PCT we are ensuring better value for money in the work we do.

 

PERSONNEL IMPLICATIONS

 

This proposal will mean the deletion of the posts of Head of Direct Services and Head of Adult Services. Both post holders have agreed to redundancy and will leave on 31st March 2003. This will mean there will be time for the new structure to be put in place. This follows the previous redundancy of the Head of Operations in May 2002.

PCT EMPLOYED POSTS :

 

There are two existing posts, which on personnel advice are eligible for slotting into the Heads of Health and Social Care Commissioning Posts. The new Senior Commissioning manager post will be advertised by the PCT in the normal way.

 

COUNCIL EMPLOYED POSTS :

 

The Head of Operations Post will also need to be filled. This will be done in the normal way. The two new Service Manager posts, which will be needed to support the Head of Operations, will also need to be filled. One post will be  filled by the current Service Manager in the Adults Division. The remaining post will be filled in the normal way.

 

LEGAL IMPLICATIONS

 

There are no legal implications arising from this paper. The duty to provide services remains with the Council.

 

BACKGROUND PAPERS

 

Paper to Executive Committee   July 2002

Various working papers for internal meetings   May-July 2002

 

Contact Point : Charles Waddicor 520600 ext 2225

 

 

C WADDICOR

Strategic Director of Social Services and Housing