Concerns over NHS integration

County councillors have warned plans to shake up the way the NHS, public health and social care services are run in Herefordshire are doomed to failure due to funding.

Central government is in the process of developing legislation to remove the barriers that prevent local NHS, public health, social care and voluntary sector services from being truly integrated.

The Department for Health and Social Care’s white paper, Integration and Innovation: working together to improve health and social care for all, aims to plan and deliver services that are wrapped around the needs of individuals.

They hope these changes will lead to more collaboration rather than competition between different organisations and services.

But councillor Alan Seldon raised serious concerns at today’s adult and wellbeing scrutiny committee meeting that the changes were destined to fail unless adequate funding for social care was provided.

“We cannot set deficit budgets,” he said.

“You guys in the health service can overrun and then assume central government is going to pick up the tab later. We can’t.

“The square has to be turned into a circle. Otherwise I think this whole plan is doomed to failure.”

He said he had a terrible feeling of déjà vu when discussing the papers as it reminded him of the short-lived move to integrate services in 2010.

“Herefordshire went on a journey of integrating primary care trust services with the creation of Hoople,” he said.

“That was all set up to integrate back-office functions of the health service and integrated care service that we started in 2009/10 only to have the rug pulled from under us by the Lansley reforms a couple of years later.”

He also said he felt the current consultation was a foregone conclusion of what the NHS wanted to do.

“I can see awful similarities to the days of Hereford and Worcester council where Herefordshire ended up at the blunt end of picking up the bits that Worcestershire had left after they had finished with them.

He said the scrutiny committee would be essential in flagging such an issue to the secretary of state.

Coun Seldon said rural Herefordshire was at risk of missing out and called for safeguards to be included to guarantee the

“We are not going to get the services we have got now if we allow this to go through in this form.

“Otherwise, people will just clear out. We’ll have a clearing of the Highlands again through lack of healthcare.”

NHS Herefordshire and Worcestershire clinical commissioning group chief executive Simon Trickett said he absolutely agreed with councillor Seldon on the point around health and social care funding.

“It is a bit of an elephant in the room. The bit missing of this jigsaw, nationally, is as a country, how do we take that forward.

“We’ve heard a lot noise from governments of various colours over the last 20 years that yes, we need to sort this, we’ve got a plan in mind but we haven’t quite got to the point of that plan coming forward.

“Undoubtedly, for all of us as citizens, it will involve some different taxation as well.”

The new policy, which is currently in development, includes the creation of an NHS integrated care services body that would take on all the clinical commissioning group statutory functions and staff.

It also includes the establishment of a unitary board to govern it and a new partnership and a duty to collaborate on health and care bodies.

New powers would also be given to the secretary of state to directly intervene in the running of local health and care services where there is a perceived need.