Councils threatened with ‘non-incentives’ to move health integration forward

The government has indicated that it will start “increasingly scrutinising” local authority performance and look at putting in incentives – or non-incentives – to encourage them to “step up to the mark” when it comes to effective health and care integration.

Speaking at yesterday’s major Health+Care conference, health minister Philip Dunne told delegates that his department will continue to work “with both the NHS and local authorities increasingly in an integrated way to try to ensure that patients are treated in a setting which most meets their needs”.

But he was extremely critical of the ‘blame game’ that often takes place at the interface between health and social care, which can be best exemplified by a recent NHS Providers report that was accused of misinterpreting how social care funding should be used: NHS bodies claimed that their local organisations had been unable to secure a commitment from councils that the £1bn social care uplift would be used to reduce delayed transfers of care (DToCs), while the LGA argued the money wasn’t just meant to reduce pressure on the health system.

Speaking at the conference, Dunne said: “I think there’s been a tendency, and I see this in the area I represent, for one side or the other of that equation to blame the other. And we are doing a lot of work now – following the Budget in particular in March, when we committed an additional £2bn of funding to be spent on social care – to ease these pressures.

“One of the consequences of that funding announcement was that we are going to be looking at increasingly scrutinising local authority performance in reducing DToCs. And the first quarterly returns are due out next month, which we’re looking at carefully to try to put in place some incentives and, if necessary, non-incentives, to encourage local authorities to step up to the mark.”

But it’s not solely down to councils to make this work, he admitted: the government will also be working with acute trusts in order to free up between 2,000-3,000 hospital beds this year, which is equivalent to around five new hospitals, in preparation for winter.

“We can expect to see hospitals, primary and community care, and local authorities working increasingly closer together to ensure people are not stuck in hospital unnecessarily, relieving pressure for NHS staff who are looking to deliver the highest quality of care to those who do have to be in hospital,” added Dunne.

Part of the issue could also be related to councils feeling shut out of discussions about health integration. Just a third of local authorities understand how accountable care systems work, for example, despite these – considered a subset of sustainability and transformation plans – being hailed as ‘the next big thing’ in terms of restructuring.

In a separation session, Sir David Behan, the chief executive of the Care Quality Commission, also revealed that the government now wants his organisation to be able to regulate local government commissioning, rather than just NHS providers. They are now looking into how this can be carried out legally, especially in the context of section 48 of the Health and Social Care Act – which essentially allows for investigations of social care services and local authorities if it is approved by the secretary of state.

Sir David was speaking as part of a panel discussion alongside Wendy Thomson, the managing director of Norfolk County Council – a job title that owes much to the local authority’s “commercial and entrepreneurial spirit”, according to her – and Dr Phil Moore, chair of the NHSCC Mental Health Commissioners Network.

During the debate, Thomson emphasised that it is fundamental to look at home support and prevention above all else, because “you don’t need to discharge someone who was never admitted” to hospital in the first place. Part of this is linked to a point made earlier in the day by Lord Carter, who leads on a major and ongoing efficiency review of the NHS: as well as improving services, the population itself has to be better educated to ensure they don’t make use of services that they don’t realistically need, or in inappropriate settings.

The health minister’s comments on social care closely trail a scathing report by ADASS from earlier this week, which found that despite the cash boost in the Spring Budget, the overall outlook in the sector has remained eye-wateringly negative.

The report prompted a handful of health and care bodies to reignite calls for a system-wide review of the care market, which prime minister Theresa May must prioritise in her administration to ensure social care is strengthened in the short, medium and long term.


There are no comments. Why not be the first?

Add your comment



public sector executive tv

more videos >

latest news

View all News


Driving forward a healthier Scotland

10/11/2017Driving forward a healthier Scotland

Dundee City Council is leading the way in boosting electric vehicle (EV) up... more >
A smarter approach to digital transformation

10/11/2017A smarter approach to digital transformation

Catherine Bright, Smarter Digital Services (SDS) manager, explains how a pa... more >

editor's comment

25/10/2017Take a moment to celebrate

Devolution, restructuring and widespread service reform: from a journalist’s perspective, it’s never been a more exciting time to report on the public sector. That’s why I could not be more thrilled to be taking over the reins at PSE at this key juncture. There could not be a feature that more perfectly encapsulates this feeling of imminent change than the article James Palmer, mayor of Cambridgeshire and Peterborough, has penned for us on p28. In it, he highlights... read more >

last word

The importance of openness after Grenfell

The importance of openness after Grenfell

Following the recent Grenfell Tower tragedy, Lord Porter, chairman of the LGA, argues that if the public are going to have faith in the safety testing process then everything must be out in the open more > more last word articles >


‘The HSCN is the realisation of industry best practice’

30/06/2017‘The HSCN is the realisation of industry best practice’

Keith Smith, public sector business development manager at Virgin Media Bus... more >

the raven's daily blog

Visual.ONS: How to compete with the big data aggregators

13/11/2017Visual.ONS: How to compete with the big data aggregators

Advertisement feature Christopher Gallagher, territory manager at SAS, explains how big data can be used by the public sector to find innovative solutions to common probl... more >
read more blog posts from 'the raven' >

public sector events

events calendar


November 2017

mon tue wed thu fri sat sun
30 31 1 2 3 4 5
6 7 8 9 10 11 12
13 14 15 16 17 18 19
20 21 22 23 24 25 26
27 28 29 30 1 2 3
4 5 6 7 8 9 10

featured articles

View all News