Clinical commissioning groups have hit out at an independent commission’s recommendation for a single commissioner for health and social care.
A report by the commission on the future of health and social care in England, set up by the King’s Fund, called for a major expansion of free social care and for councils’ care budgets to be pooled with NHS cash and ringfenced.
It stopped short of saying which organisation should commission services from the pooled budget, but suggested a version of health and wellbeing boards could in future carry out this role.
Responding to the report, A New Settlement for Health and Social Care, Steve Kell, co-chair of NHS Clinical Commissioners, the membership organisation of CCGs, disagreed with the recommendation for a single commissioner. “This would represent another top-down reorganisation and would put at risk the essential clinical leadership we have seen develop as a result of clinical commissioning,” he said.
“CCGs are starting to address many of the issues around fragmented commissioning. They are working in partnership to develop local solutions for their populations. Local authorities and the NHS are increasingly working together, and we must allow this relationship to develop. Health and wellbeing boards are an important part of the new system, but are not commissioning bodies and are not ready to take on new responsibilities.”
Meanwhile, a London council warned it would be “impossible” to deliver an integrated service without a sustainable funding approach to local government and the NHS.
However, shadow health secretary Andy Burnham described teh report as “bold and timely”, and as an endorsement of “Labour’s call for a new settlement for the NHS and the full integration of health and social care”. People close to Andy Burnham have previously called for health and wellbeing boards to control the NHS’s commmissioning budget, although this is not Labour policy.
“The simple fact is that there is no sustainable future for the NHS in the 21st century without a long-term solution for social care,” he said. “It is only by better supporting people and their carers that we can avoid huge expenditure on avoidable hospital admissions.
“This is why Labour is committed to building an NHS for the whole person, providing personalised care in people’s own homes with a single point of contact for all their needs.”
Krupesh Hirani (Lab), Brent LBC’s cabinet member for adults, health and wellbeing, said full integration of health and social care was what local authorities should be aspiring to.
“However, while spending on health is increasing, although not at a fast enough rate, funding for adult social care and local authorities is being cut between a half and third over the next two to three years, so the pressure on the whole system is huge, but it is even harder on councils such as Brent,” he said.
“The commission’s recommendation requires an increase in public spending on health and social care to rise to 11 to 12% of the UK’s GDP, however current government spending plans will bring spending in this area to only 8.5% of GDP in 10 years’ time.
“Without a sustainable funding approach to local government and the National Health Service it will be impossible to deliver this aspiration.”