TITLE :
PART 1
(OPEN TO THE PUBLIC)
ITEM No
REPORT OF THE LEAD MEMBER FOR ADULT SOCIAL CARE
CABINET MEETING – 23rd MAY 2006
OUR HEALTH, OUR CARE, OUR SAY: A NEW DIRECTION FOR
COMMUNITY SERVICES
FORECOMMENDATIONS:
That Cabinet considers the implications of the White Paper in preparation
for the Joint Meeting with the Primary Care Trust Board on 13 June 2006.
EXECUTIVE SUMMARY:
This key White Paper sets the future direction for social care and primary
health care. It follows an extensive public consultation and has important
implications across the Council, the NHS and the community, voluntary and
independent sectors.
BACKGROUND DOCUMENTS:
Independence, Well-being and Choice – D o H March 2005
Choosing Health: Making healthier choices easier – D o H 2004
Health, Work and Well-being – caring for our future – DWP October 2005
Creating Sustainable Communities: Supporting Independence OPDM
November 2005
Local Strategic Partnerships: Shaping Their Future - ODPM December
2005
ASSESSMENT OF RISK:
Not relevant at this point.
SOURCE OF FUNDING:
None at present
LEGAL ADVICE OBTAINED:
None
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FINANCIAL ADVICE OBTAINED:
No
CONTACT OFFICER:
Anne Williams – 0161 793 2200
WARD(S) TO WHICH REPORT RELATE(S):
All
KEY COUNCIL POLICIES:
PURPOSE OF REPORT:
To brief members about the White Paper which sets the future direction for
social and primary health care.
CONSULTATION:
There was widespread consultation locally and nationally on
“Independence, Well-being and Choice” and “Your Health, Your Care, Your
Say”, earlier consultation papers.
DETAIL:
1.
INTRODUCTION
1.1
In February 2006 the Government published a White Paper, “Our
Health, Our Care, Our Say: a new direction for community
services.” The White Paper follows a Green Paper, “Independence,
Well-being and Choice” on the future of Adult Social Care and
extensive national and local consultation.
1.2
The White Paper sets the direction for the future development of
community based health services and adult social care. It
addresses the major challenges facing local government and the
NHS in tackling health inequalities, an aging population and the very
significant and growing percentage of the population with long term
needs such as diabetes, stroke, high blood pressure and cardio
vascular conditions. It is addressed to the NHS and Councils as a
whole.
1.3
The White Paper makes extensive links with other Government
policies such as the development of Local Strategic Partnerships,
the thinking around devolution of certain responsibilities to
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neighbourhoods, the future funding of social care (the Wanless
report), Every Child Matters, the employability agenda, and the
importance of regeneration in building sustainable communities and
in securing housing for a changing population.
2.
KEY MESSAGES
2.1
Personal control and empowerment
Giving people more personal choice and control over their health
and social care through:
 Better information and access to services
 An increased take up of Direct Payments
 The introduction of individual budgets bring together several
income streams from social care, equipment, access to work,
Independent Living Fund, Disabilities Facilities Grants and
Supporting People
 The development of Personal Health and Social Care Plans
 The development of integrated social and health care records
 Care closer to home with more services delivered in the
communities
 More self care through the expert patient programme,
telemedicine and telecare
2.2
A radical and sustained shift to better prevention services and
earlier intervention
 “We will shift the whole system towards the active, engaged
citizen in his or her local communities. Closer working
between Local Government, through Primary Care Trusts and
GP practices.
 An NHS “Life Check” – assessment on line or in hard copy
 Specific health and social care advice and support
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 The development of a campaign for a “Fitter Britain”
 A shift in spending from hospitals to primary and social care
2.3
Better future planning, commissioning and procurement
between Primary Care Trusts and Local Authorities
 Through Director of Public Health as a joint appointment with
a wider role
 A strengthened role for the Director of Adult Social Services
within the Local Authority.
 The Director of Adult Social Services, the Director of Public
Health working across local authorities, undertaking regular
strategic needs assessments which look forward over 10 to 15
years and take account of the needs of the whole population
 The development of a procurement model and best practise
guidance to underpin a joint commissioning framework for
health and well-being
 The streamlining of budgets and planning cycles between
Primary Care Trusts and Local Authorities
 More joint appointments
 A shared outcome-based performance framework
 Aligned performance assessment and inspection regimes
 Local Area Agreements as key mechanism for joint planning
and delivery
2.4
Integrated health and social care services through:
 A Common Assessment Framework
 An integrated health and social care information system
 Creation of multi-disciplinary networks and teams
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 More use of integrated intermediate care
 Co-ordinated services for Carers
2.5
A summary of key points is shown in the attached appendix.
3.
Implications and opportunities for the Council
3.1
The opportunities:
 A Single White Paper a good news and recognises the vital
contribution Local Government makes to the health and wellbeing of local people
 Political, strategic and operational leadership and trust
between the Council and the PCT is a strength in Salford
 The broadening role of social care to well-being and inclusion
fits with the Council’s grouping of Neighbourhood, Culture,
Leisure and Adult Social Care in one Directorate
 The Council and Primary Care Trust already have several
joint appointments, integrated services and pooled budgets,
with plans for more developments this year
 The Council and Primary Care Trust are already working on
the reduction of health inequalities and joint commissioning
 The Council and PCT have developed the Well-being
Strategy for Older People and there is cross Council
engagement with its implementation
 The Council is a high performer in the uptake of Direct
Payments
 Plans are advanced across social care and housing for the
use of telecare
 A strategy for housing for older people is being developed
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 A cross Council group is engaged with the employability
agenda
4.
Implications for the Council
4.1 The challenges
 There remain stark health inequalities in Salford across socioeconomic groups and in different communities.
 The financial position in the NHS and Local Authorities is
forcing withdrawal from preventive services and tightening of
eligibility criteria.
 Historically, it has proved very difficult to move resources from
secondary (hospital) care to primary care and from NHS to
Local Government.
 Demographic change in relation to older people and children
and adults with complex, multiple disabilities are a very
significant pressure for Central and Local Government.
 Getting the governance right between the Primary Care Trust
and the Council as more and more services/budgets/systems
are integrated will require detailed work across Human
Resources, I.T., Finance, Adult Social Care and
Neighbourhood Services.
 Local Area Agreements are still new and the White Paper
envisages large-scale agreements.
 Turbulence in the NHS and conflicting policies could be
diverting and risky.
 If the changes in the White Paper are successfully
implemented there will be a significant impact on the future
shape of hospital services in terms of size and number.
 Working with GP’s and practise based commissioning is new
and will require very careful planning to secure a smooth
transition from existing arrangements and avoid
destabilisation.
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5.
Conclusion
5.1
The White Paper, “Our Health, Our Care, Our Say” sets out an
agenda for Primary Care Trusts and Local Government to meet
people’s expectations for community health and social care services
in the 21st century. If these expectations are to be met, a significant
shift in resources and services will be required to develop more
preventive services and early intervention, better joint
commissioning and integrated services. Without these changes,
demographic pressures threaten to overwhelm existing patterns of
service.
5.2
The White Paper endorses the key role of Local Government as a
whole in meeting this challenge, working with Primary Care Trusts.
5.3
The Council is well placed to implement the White Paper
recommendations, working ever more closely with the Salford
Primary Care Trust, the Local Strategic Partnership and providers in
the Private and Voluntary Sector.
5.4
Implementation will require engagement and detailed work across
the whole Council.
6.
Recommendations
6.1
The Council, in considering the White Paper, will want to discuss
with the Primary Care Trust, the implications in terms of future
models of providing services.
6.2
The Council can link on-going work on the Research and
Intelligence Unit with the new joint responsibility for a strategic
needs assessment.
AEW/AW
May 2006
Cabinet Report 9 May Our Health, Our Care, our Say.doc
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