Seven areas with high levels of health and social care integration have formally warned the government that its “inflexible” approach to NHS reform will force them to dismantle their current arrangements.
Letters to health secretary Andrew Lansley, left, and communities secretary Eric Pickles from a group of councils and PCTs including Blackburn with Darwen and Bexley NHS Care Trust, argues that they should be exempt from joining PCT clusters as demanded by NHS chief executive Sir David Nicholson.
The council leaders and PCT chairs say their concerns relate not to the Health and Social Care Bill, but to the transitional arrangements to pave the way for GP commissioning and the abolition of PCTs in 2013.
They write: “Whilst fully supportive of the need to ensure resilience and assured accountability in the NHS system during the coming period of significant change and beyond, we feel that the seemingly inflexible requirement for a uniform approach to how that resilience is to be delivered will produce costly and other unintended negative consequences for the delivery of local public services.”
The leaders state that fully-integrated management structures like Herefordshire’s, and Integrated commissioning models like those operated between Knowsley MBC and NHS Knowsley were developed in response to local need and are “a visible demonstration of successful localism”.
They continue: “The attempt to insist upon a single clustering arrangement across the country places these local arrangements at risk; this risk is made even greater by the pace at which the proposals are being driven through by the strategic health authorities.
“Although the guidance issued by the Department of Health on 31 January makes reference to the fact that the transitional arrangements ‘…should not lead to the dismantling of effective PCT/LA arrangements’, unless a more flexible and locally responsive approach is facilitated, that is exactly what will result.”
The letter goes on to argue:
- A one-size-fits-all approach to the creation of PCT clusters is unnecessary
- Clustering will create additional HR difficulties in situations where joint appointments are posts held by council staff
- Dismantling existing arrangements will lead to increased costs at a time when greater efficiencies are demanded
- A universal approach to clustering goes against the grain of the local arrangements being evolved by GP consortia and early-implementer health and wellbeing boards.
The letters are signed by: NHS Blackpool chair Roy Fisher, Blackpool BC leader Peter Callow (Con), Bath and North East Somerset Council deputy leader Malcolm Hanney (Con), NHS Knowsley chair Rosemary Hawley, Herefordshire Council leader Roger Phillips (Con), NHS Herefordshire chair Joanna Newton, NHS Southwark chair Mee Ling Ng, Bexley NHS Care Trust chair Barbara Scott, and Blackburn with Darwen Care Trust chair Sir Bill Taylor.