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Stevens: We cannot rely on Treasury over social care impact

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The Treasury cannot be relied upon to quantify the impact of adult social care pressures on the NHS, Simon Stevens has said.

Appearing at the Association of Directors of Adult Social Services Spring Seminar yesterday, the NHS England chief executive referenced a commitment from government last summer that “there will be no additional pressures on social care through to health”.

He added this will need to be “fleshed-out” by the NHS and local government together to “hold policy-makers’ focus” as funding is set in this year’s spending review.

When later asked whose responsibility it will be to quantify the impact of social care on the NHS he said: “We need to work together on that. You can’t rely on the Treasury, excellent though they are, to quantify these matters. We need to bring evidence to bear as well.

“So between local government, the NHS, academic partners [and] the third sector, we have got a job of work over the next few months to make sure that evidence is available to the decision-makers.”

He also referred to the proposal in the NHS Long Term Plan to review councils’ commissioning responsibilities for sexual health, health visitors and school nurses.

Mr Stevens said the plan “is a complement to, but cannot be a substitute for the role of local government, particularly on prevention and public health”.

He added: “It is blindingly obvious that we can only do this with local government and the NHS together, whether it be the epidemic of knife crime [or] the increased attention on air pollution.

“In some parts of the country some of our leaders need to stand alongside your elected leaders and make the case for action in reducing small particulate and diesel emissions because if we don’t do that our place as one of the worst respiratory offenders for child health across Europe will continue and we will see the continuation more broadly of the population health threats which are at risk of undermining decades worth of progress in children and young people’s health.”

Mr Stevens said he “would hope” directors of public health and elected members can work together on reducing health inequalities through the “billions of pounds that flows” to the worst affected parts of the country.

He was also questioned on the future of health and wellbeing boards, in the context of the legislative changes proposed by NHS England in February which would see the creation of joint boards of providers and commissioners that may include local government in every integrated care system. Intergrated care systems are developing out of sustainability and transformation partnerships and are due to cover the whole country by 2021. 

Mr Stevens responded: “I don’t think it needs affect health and wellbeing boards. We value the work that health and wellbeing boards are doing.

“If someone wants to come forward and say there should be an alternative structure then let’s have that discussion.”

He said the proposals had been developed following a ”quite specific” request from the the prime minister to look at what legislative changes would be needed to support the development of integrated care systems. 


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