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Integrating local government and the health service

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There was considerable reaction to my suggestion that the clinical commissioning group (CCG) authorisation process should have some mechanism for considering options around shared services across local government and health. This is good because an open debate on such an important issue is essential if we are to understand how the NHS is going to manage the complex commissioning of services that span across both sectors.

If the NHS and local government begin to retract from each other they will simply store up greater problems further down the line which is where my concerns lie. By linking this to the authorisation process CCGs can be challenged as to whether they have considered this as an issue.

Playing devils advocate you could argue that if a CCG has not considered integrating back office functions how are they intending to share commissioning on services such as mental health, and childrens health?

At the very top of the NHS there is a definite commitment to explore innovative service delivery models and in Blackburn with Darwen we have shown that integration of back office functions such as communications and engagement, intelligence and HR can improve the way these services are delivered whilst at the same time realising cashable savings.

Playing devils advocate you could argue that if a CCG has not considered integrating back office functions how are they intending to share commissioning on services such as mental health, and childrens health? This isn’t about having a veto but instead ensuring CCGs fully understand the complexities of tackling these problems when the solutions lie not just in NHS services but within services provided by councils. Councils are in a minority amongst health professionals on the authorisation panels. We are there to put a challenge in if we think the NHS is too inward looking. 

Whether some people like it or not, the NHS and local government is now so closely intertwined that the days of operating in silos are gone. As public health moves into local government health professionals are already starting to challenge councils to put health improvement at the forefront of our agendas around housing, education, licensing and regeneration – and we are responding.

Most people will look towards their councils to guide them through services that are available at a local level particularly for some of our more vulnerable residents. It would therefore be a real shame if the NHS does not grasp the opportunity presented to it to integrate some of its service delivery with local government bringing the kind of transformational change many in the government talk about wanting to achieve.

Graham Burgess, chief executive, Blackburn with Darwen BC and NHS Blackburn with Darwen Care Trust Plus

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