Exclusive: PCT reform delays social care merger

Plans to merge health and social care work have been set back by the recent PCT reconfiguration, but may be the stronger for it in the long run.  

Speaking exclusively to GP, Andrew Cozens, strategic adviser on children, adult and health services for the government’s Improvement and Development Agency, said councils and PCTs were ‘still largely finding their own way’, and halving the number of PCTs this month had delayed implementing joint working.  

Mr Cozens’ comments follow a series of meetings around the country to assess the implementation of changes to social services structures introduced two years ago.  

Much of the feedback was negative, he said, because the meetings coincided with cuts brought on by recent NHS deficits and those present had found joint working difficult.  

‘Outside London, well-established partnerships have been shaken up by the reorganisation,’ he said. ‘In the long term, more boundaries will be coterminous with councils. It’s too early to say if that will be significant, but having the same populations should help.’  

Mr Cozens said that mutual council and trust boundaries could have a number of other benefits for GPs and councils alike as ‘a lot of what councils know about populations is very useful for GPs and vice-versa’.  

He said that a number of PCTs were considering joint appointments with local councils to further integration.  

He also stressed the importance of shared data and knowledge in a number of ways.  

‘There is a growing trend in co-location of staff as it is important to share knowledge,’ he said.  

‘Single-handed GPs are very busy and finding time to be represented is quite problematic.’  

He predicted that although this may lead to fewer single-handed practices, he also thought they had a strong role to play and that it may lead to ‘stronger formal or informal groupings’ of practices like practice-based commissioning (PBC) consortia.  

However, Mr Cozens stopped short of saying that PBC could provide the means of completely unifying health and social care budgets, instead saying that PBC could throw up lots of ‘creative ideas about how patient needs can fit with practices’. 

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