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County calls for health and care commissioners

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Health and care commissioner posts should be created to end the fragmentation of services, Essex CC has said.

In a paper written by a number of its policy officers, the council said these posts could be appointed or elected.

In either case commissioners would “provide an accountable and visible figure for local populations” and would chair health and wellbeing boards, holding budgets for health and social care and directing the commissioning of services.

The government should give budgets for health and care to health and wellbeing boards in a 10-year funding settlement that would allow long-term planning and the opportunity to shift spending into prevention, the paper A Shock to the System: Saving our Health and Social Care, said.

“It is clear that leadership and accountability over local health and care services is fragmented,” argued the paper.

“Local health and wellbeing boards are new creatures of statute but they have the potential to bring leadership and budgets together in a natural arena.”

Each area should be free to determine its arrangements, “but there should be a clear duty on boards to reduce variability in outcomes within their boundaries and an explicit assumption that joint commissioning is a way of achieving this”, it stated.

In a foreword, Essex leader David Finch (Con) said: “Our health and adult social care systems are under increasing pressure and the voices of concern are getting louder.

“There is a growing consensus [they] are unsustainable and will face a considerable funding gap by the end of this decade unless there is action.”

The paper also called for reform to the NHS tariff system “to incentivise prevention and align financial incentives for providers with health and social care outcomes for individuals”, and a legal presumption in favour of sharing data on individuals, though with a right to opt out.

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