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Joint working with NHS 'becoming difficult'

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The head of Public Health England has called for the “acceleration” of pooled budgets between councils and the NHS, amid concerns from the King’s Fund thinktank that financial pressures are inhibiting joint working.

A report from the King’s Fund, published today, said “serious financial pressure” on acute trusts in the NHS was making it difficult for councils’ adult social care directors to work with the groups.

“There is no shortage of commitment or goodwill towards joint working, but as the financial and service pressures tighten, this is becoming much more difficult”, it said.

However, Duncan Selbie, chief executive designate of Public Health England, told LGC there was “nothing stopping” local government from pooling budgets with clinical commissioning groups to fund social care and a range of other services.

“I think the report highlights assumptions that we’re spending money well now, and I don’t think that’s a fair assumption”, he said. “Is the NHS getting value for every pound? I don’t think so.”

Mr Selbie said councils and clinical commissioning groups should get together to discuss radical new ways of funding services instead.

“CCGs and local government already have the power to pool budgets”, he said. “I’d expect them to be making agreements about what they’re trying to achieve and where the benefits will fall. I’d like to see pooled budgets really accelerate.”

Asked whether the complexity of sharing out resources was a hindrance to pooled budgets, Mr Selbie said: “It’s not complicated. Travelling to the moon may be complicated. It just needs people to agree.”

Richard Humphries, a senior fellow at the King’s Fund, told LGC: “In some cases [with tight budgets] the tendency is that organisations look to manage their own budgets and their own pressures. It does encourage people to go back into silos.”

He said partnership between local government and the NHS was “more important than ever but harder than ever”.


The King’s Fund’s Quarterly Monitoring Report also found:

  • Almost half of directors of adult social services thought that the quality of services they commissioned had worsened in the past year.
  • Nearly a third of adult social care directors predicted an overspend on their budgets.
  • More than a third anticipated having to reduce services over the next year.
  • More than half of NHS finance directors said their trust had been affected by councils’ funding settlement. The effects included problems with discharge arrangements caused by the withdrawal of social work support services.
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