By Judith Ugwumadu | 4 March 2015
English counties are today calling for the devolution of health and social care systems, warning that centralised NHS structures are causing barriers between services.
A new report from the County All-Party Parliamentary Group, State of care in counties, identified a set of challenges facing counties when it came to providing adult social care.
It said nearly eight in ten counties felt funding pressures in adult social care were ‘severe’ or ‘critical’, while only a quarter (23%) described them as manageable. Counties only received an extra £496 per head, compared to the £1,957 gained by inner-London authorities, the report noted.
It argued that the impact on the NHS was demonstrated with delayed discharge rates 43% higher in counties.
The report also warned that a devolution divide could open up between urban and metropolitan areas, increasing social care pressures in county areas, following last week's announcement of plans that the combined authority in Manchester will control their entire £6bn health budget.
The MPs suggested that the incoming government should invite local NHS/local authority partnerships to bid for greater devolution of health and social care through Health & Social Care Deals. These would provide pooled budgets, new delivery structures and enhanced local powers.
Health & Wellbeing Boards would hold the integration programme to account and drive it locally. The boards should be given additional powers to commission primary, secondary and social care services, the APPG recommended.
Additionally, the newly elected government should conduct a full review of the sustainability of adult social care as part of the 2015 Spending Review, including allocation formulae.
APPG chair Henry Smith said the ‘unique’ pressures in county areas meant government still had work to do in removing the barriers to integration.
‘The Manchester announcement underlines that devolution is the way forward for health. The pressures on their services are not as high as in county areas and this strain will only increase over the coming years – and the need to break down the operational silos,’ Smith said.
‘By aligning targets across the NHS and local government, devolving control and providing a fairer funding settlement, care in county areas can continue to improve and meet the future needs of local people.’
