Guidance on the implementation of the Health Act 1999 partnership arrangements has been issued. The aim of the Act is to improve services for users, through pooled funds and the delegation of functions.
These arrangements provide an opportunity for councils, health authorities and trusts to pool resources into a discrete fund. This will enable the provision of
'customercentric' and seamless health and social services care, avoiding the potential for pitfalls inherent in different agencies providing different elements of similar services.
Under the joint agency guidance several joint boards are responsible for delivering seamless services - mental health, children's services and learning disability. With an eye to future expansion of partnership working, shadow boards exist for elderly and physical disability services.
A robust financial framework is crucial. Pooled budget and staffing arrangements for the established mental health services board provide a template for BarnsleyÕs group. Key issues within the financial framework include:
- Processes and protocols for varying pool contributions by either partner
- Differential grant regime funding together with adequate audit arrangements
- Protocols for over and underspending
- Agreements on potential annual differential inflation in respect of partner
- The approach to efficiency targets
- General budget management and reporting to the boards and the group.
The extent of delegation by the council to the group and its potential as a precepting body has also been considered. The real added value will be measured in terms of services for users and carers, eliminating old squabbles about social and health baths, temptations to define problems away as the responsibility of the other service and associated cost-shunting.
Even greater gains may be experienced by integrating multi-disciplinary assessment teams. The real issues are different organisational and professional cultures which historically have been barriers to effective partnership working.
There has to be one fly in the ointment. Councils and health authorities are governed by different VAT regimes. Significant issues on VAT remain and clarification from HM Customs & Excise is awaited.
If partners can avoid trying to convince the government they would be better off providing all of the services there is a real opportunity to provide integrated and local solutions to local problems.