England & Wales Health and social care, Personal and organisational development

The State of Care in Counties Inquiry

Photo Credit: Karen Roe via Compfight cc countryside older people

Progress towards health and social care integration has been uneven across the country. In Manchester we have seen a commitment that the £6bn health and social care budget for Greater Manchester will be taken over by regional councils under devolved NHS powers, in a plan that will come into force from April 2016.

It’s encouraging that the Government is recognising that big challenges like health and social care integration can only be solved at a more local level.  One of the key messages to come out of responses to the State of Care in Counties Inquiry (launched today) is that the highly centralised nature of the NHS acts as a barrier to better integration of health and social care locally.

But it raises a serious question – if this approach works for Manchester, then why not for other parts of the country? The pressures on adult social care and health are much greater in counties than in a city region like Manchester, as this report reveals.

Counties provide a home to far greater number of older people, and they receive a far smaller proportion of the funding per head of population. Their organisational landscapes are also much more complex and sit less comfortably under a top-down integration programme like the Better Care Fund.

More local control of pooled budgets would cut through some of these challenges and allow more locally tailored responses.

Strong governance arrangements are a must, but this comes best from local leaders, and responses to this Inquiry show there is a lot of appetite for more local autonomy on the health and social care agenda.

Manchester has shown the way – we must take up the challenge and call for similar Health and Social Care Deals to be extended to county regions. The recommendations in the report only mark the starting point of what we hope will be a transformative discussion.