Monday, 2 August 2010

Health and Social Care; a happy marriage?

For the past few years the biggest buzz phrase among senior managers was 'joint working.' Unlike such derided management-speak phrases as 'blue sky thinking' Joint working meant something real, a long overdue acceptance that social care and health are inexorably tied together. The real initiatives which emerged from this were the rehab teams; jointly staffed by community nurses, Physiotherapists, occupational therapists, care managers and social workers. The teams also had access to rehab carers who were specially trained to provide assistance, but in a way which enabled the service user to maximise their independence; working toward a set of user defined goals which could range from running a marathon to making a cup of tea independently.

The teams were not without problems, one which stuck out was the cultural difference between health staff and social care staff with the former being used to far more status, professional autonomy, and possessing slightly different recording practices, but these were small and something which could be resolved over time. For me it always seemed these teams were the way forward, the sensible future for social care. Senior managers seemed to agree, the teams were innovative and with the emphasis on reducing dependence could potentially be far more cost effective.

This has led to me prophesy a marriage between health and social care. The organisational divide between the two, one PCT controlled, the other LA controlled has long seemed a bit arbitrary especially when joint-working has achieved real differences on the ground. The question was however, what organisation would give way. I long believed this to be LAs who I felt, certainly in my case, seemed to be disposing and delegating as many functions as possible in the name of cost-cutting.

But how wrong I was. It is PCTs who now see their days as numbered leaving LAs, as this Guardian article suggests, invested with the governance of health and social care.

Having not got my head round the proposed reforms to the NHS I'm unsure what this means for the future - (for my part the current system seemed to be working very, very well so I'm perplexed by the need to change it) but, the article expresses my chief concern at this stage; Can LAs handle the increased responsibility?

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