System shuffle requires fast footwork
Have you noticed that when the government identifies a ‘wicked issue’ - those critical but tricky-to-tackle problem areas - the answer is often to give it to someone else to fix.
Local government is frequently the recipient of such a handover, and it is never plain sailing. There is a great deal of this about at the moment - arising from health and welfare reform.
The transfer of public health responsibilities to local government is a ‘homecoming’ in the eyes of many. However, it is a homecoming that involves a shift in responsibility for some of our most ingrained wicked issues - obesity and physical inactivity among them.
It is true that preventing ill health has much to do with information, education and lifestyle - very much the province of local government. Yet the challenge that the sector is accepting is that of attempting to change the culture and behaviours of a nation … not easy in anyone’s book.
Then some other shifts - blue badges have gone national, well sort of. We have a national system of issue with a local system of assessment.
The issue being addressed is fraudulent use of badges. At the same time there is an attempt at channel shift, with an online application and payment system set out in the reforms.
However, the early impact of the ‘streamlined’ system has been an increase in processing time and a loss of local control over when badges will actually arrive.
Other changes are afoot -the abolition of the social fund is planned with funds and responsibilities transferring to local authorities from April 2013.
This reform seems to be about capping expenditure and also allows the Department for Work & Pensions to close expensive out-of-hours services.
The transfer of the independent living fund (ILF) and support for those who access it is out for consultation now. It’s good logic to bring together funding for care, but this is an odd one; the distribution of people accessing ILF funding is extremely uneven, and in this case localisation seems to be as much about capping cost as about improving distribution.
Councils need to stay alert to keep up with the fast footwork of the system shuffle.
Sarah Pickup, president, ADASS
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Letters to the Editor | 11-Sep-2012 3:08 pm
In her comment piece in the August 23 LGC, Sarah Pickup, president of the Association of Directors of Adult Social Services offered views on how local government is often handed tricky situations to fix. She clearly has very strong views on the challenges awaiting local government as the transfer of public health responsibilities takes place
Whilst everyone is familiar with some of the headlines coming out of current health reforms, things are rapidly moving from plans to implementation. For local authorities that implementation is inevitably focussed rather heavily on how their new responsibilities can be delivered as cost effectively as possible.
It’d be very easy to be overwhelmed by all of the new responsibility but that’s not what we do in local government. One of those impending responsibilities is the awarding of new contracts for the NHS Complaints Advocacy Service. The previous contracts, awarded by the Department for Health, are due to run out next spring.
For many local authorities, the sums really only add up if they prepare for this change as a group. That was the decision quickly made by eleven local authorities in Tyne and Wear and Tees Valley. Lead authority, Gateshead Council, has been joined by Newcastle City Council, South Tyneside Council, North Tyneside Council, Sunderland City Council, Durham County Council, Stockton on Tees Borough Council, Hartlepool Borough Council, Middlesbrough Borough Council, Darlington Borough Council, Redcar & Cleveland Borough Council.
One of the early successes of the joined up approach was support from ADASS. With high level support and agreement other key decisions were quickly made including the outline contract value and the distribution of funding.
While the signing of the contract with the eventual provider is still some way off, the group has already learned a lot. Lead officer Andi Parker was asked to take part in a Local Government Association NHS Complaints Advocacy Master class event to share experiences and lessons from leading the Collaboration.
Her advice included just how important it is for all of the participants to sign up to a collaboration agreement. With that in place a strong lead authority can take leadership, provide direction, set and meet timescales and keep all parties involved and informed along the way. The importance of early involvement from a variety of different disciplines was also flagged up; legal, finance, procurement, development and commissioning officers all playing a key role.
Work is now very firmly focussed on procurement and finding a robust way of ensuring that the eventual service provider can give clients consistent and high quality complaints advocacy advice.
Sometimes it’s those voices that most need to be heard that can struggle to rise above the noise. Too often it is those that most need to speak that feel unable to do so.
If all goes well, some of the most vulnerable people in the North East will have a first class complaints advocacy service. If that does happen then clients will never need to know of the huge amount of work that’s gone on behind the scenes during this seismic shift in health provision. It will be very interesting to see how the general public eventually view the new health roles of local authorities, but the resolve to make these changes as successful as possible is clearly there.
David Bunce
Group Director, Community Based Services,
Gateshead Council
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