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Stevens: NHS social care services would create 'backdoor' pressure

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The direct employment of social care staff by the NHS “across the country” is not a solution to the sustainability of services as it would create a “backdoor” funding pressure for the health service, NHS England chief executive Simon Stevens has said.



In an interview with LGC’s sister title Health Service Journal, Mr Stevens said there was no one size fits all approach to the sustainability of social care.

Asked whether he had found an answer in new models such as the “enhanced health in care homes” vanguards, or Salford Royal Foundation Trust’s taking on social care responsibilities, Mr Stevens said there were examples around the country that were having an impact.

He cited the reduction in delayed discharges at Oxfordshire’s John Radcliffe Hospital after the Oxford University Hospitals Trust began directly employing social care workers.

However, he added: “But what we can’t do, I don’t think across the country as a whole, which would be another sort of backdoor funding pressure on the NHS, is begin to employ at Agenda for Change rates, staff who properly are social care staff.

“But there will be places where people can work out the sweet spot. Tameside I think are doing something similar.

“So my point of view is we would be wrong to mandate a national answer, which is to say the answer is Oxfordshire, or Tameside. These are decisions that need to be made between consenting adults – local authorities and the NHS leaders locally, informed consent.

“I very strongly think it would be a mistake to try and mandate one single solution across England.”

Mr Stevens also used the interview to again hit back at councillors who have taken issue with their local sustainability and transformation plan.

A number of council leaders and Birmingham City Council chief executive Mark Rogers have publicly complained about the lack of focus on social care and its funding pressures in their STP.

But Mr Stevens said the NHS budget could not be expected to absorb all of the pressures on social care.

He said: “The first point to make is that – and it relates to the local dynamic with councils through the STP process as well – the NHS’s budget settlement in the spending review was not intended to, and obviously cannot absorb, all the pressures in the local authorities [and the] financial pressures on their side.

“That fact should not be used as a reason for individual councillors or NHS bodies taking issue with the broad direction being set out in the STP.”


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