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WHITE PAPER REACTION: RECOGNITION THAT COUNCILS ARE CRITICAL TO DELIVERING COMMUNITY WELL-BEING

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England's Social Care Commission today strongly backed the vision set out in the Government's White Paper 'Our Heal...
England's Social Care Commission today strongly backed the vision set out in the Government's White Paper 'Our Health, Our Care, Our Say'*.

CSCI chair Denise Platt stressed that good social care and health services in community settings are crucial to help people achieve the independence they seek.

She said: 'Ever since we started work in April 2004, we have emphasised what people repeatedly tell us - that they want to live independent lives wherever possible and so want real choice and control over any support or services they may require to achieve that.

'We are particularly pleased to see a number of statements and policies in the White Paper which will help to focus the attention of social care and health services on people's needs.'

These include:

- strong endorsement of the proposed outcomes for people who use social care, against which services should be measured;

- the recognition of the need to do more to support informal carers. We have frequently stated the case for such support;

- recognition that local councils are critical to delivering community well-being;

- closer alignment between council and Primary Care Trust boundaries and the realignment of planning and budgeting cycles across councils and the NHS.

Dame Denise continued: 'The Commission's work tells us that a well-trained workforce, better commissioning and listening closely to people who use services are essential ingredients in good social care.

'Over the next year, the Commission will focus on all these aspects to help turn the White Paper's proposals into a new reality for people who use services and their carers.'

* White paper Our Health, Our Care, Our Say

Statement from the King's Fund follows.

GOVERNMENT VISION FOR FUTURE OF PRIMARY CARE RIGHT BUT MAKING IT A REALITY POSES MAJOR CHALLENGES

The government's ambitious agenda to reform primary care services will fail unless the huge financial pressures facing the NHS are managed effectively and Ministers introduce the right incentives to enable services to be delivered closer to people's homes.

That was the message from the King's Fund today in response to the government's White Paper on improving community health and care services. Speaking in response to Our Health, our care, our say: a new direction in community services, King's Fund chief executive Niall Dickson said:

'The White Paper offers an unprecedented opportunity to redesign community health and social care services,' he said. 'The government has outlined an ambitious agenda and we welcome the government's vision of shifting care from hospital settings into the community - this is long overdue. We also support measures to introduce more accessible, convenient services in local settings and better integrated care - particularly for patients with complex needs and long term conditions.

'But we must not underestimate the challenges ahead - we've been trying to do thisfor more than 30 years with limited results. And today's announcement has to be seen in the context of a health service that is struggling financially and finding it difficult to meet all the demands being placed on it. This is likely to be one of the rockiest years the NHS has faced and keeping the whole system going while encouraging local organisations to change the way they operate will not be easy. What is more some of today's proposals designed to increase access to services may encourage more use by the worried well of scarce health resources.'

On strengthening commissioning

Commenting on government plans to give family doctors more responsibility for local health budgets, Niall Dickson said: 'Practice-based commissioning is crucial if the government's vision of shifting more care into the community is to be delivered. The White paper sends us in the right direction but we are concerned that there is not enough in the proposals to engage family doctors and encourage them to take more responsibility for budgets. Without the active support of family doctors these plans will fail. To achieve this we need the right balance between giving family doctors the freedom to innovate and rewarding them for this, while holding them to account for the services they provide.'

On allowing different providers to compete for services

Commenting on government plans to encourage more alternative providers in primary care, Niall Dickson said: 'For too long patients, particularly those in deprived areas, have been poorly by community health services. Accordingly we support government moves to inject a degree of competition by opening the door to more alternative providers, including those from the voluntary sector. This will not mean a cut throat market but it should encourage new players to come in and provide services in areas where services are not delivering.'

On new NHS 'life checks'

Niall Dickson said: 'The government is right that the NHS should provide better prevention and earlier intervention. The new NHS 'life checks' could help to uncover serious illnesses, such as heart disease, before they deteriorate to a point where high-risk patients in particular need expensive and disruptive hospital treatment.

'But we do need to be cautious - there is a limited evidence base to suggest that MoT-style checks are a cost-effective way of targeting people most at risk of ill health. They could swallow up resources without delivering the benefits intended.'

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