Council leaders have warned that local government needs to be an equal partner in the design of any national oversight of social care as the Government sets out its white paper plans to overhaul the NHS.
The Government has said the white paper contains proposals to build on the ‘successful NHS response to the pandemic’, with health secretary Matt Hancock saying they would cure the NHS of red tape.
Chair of the Local Government Association’s (LGA) Community Wellbeing Board Cllr Ian Hudspeth said councils understood the Government’s desire for greater transparency in social care, ‘but councils need to be an equal partner in the design of any national oversight’.
This needed to ‘build on existing sector led improvement work, recognise local democratic accountability and give a voice to people who use and work in social care’.
Cllr Hudspeth also emphasised the proposals ‘do not address the need to put social care on a sustainable, long-term footing, nor the wider changes needed to ensure care and support can best enable people to live the lives they want to lead’.
Key measures in the white paper will include scrapping dozens of bodies and for the NHS and local government to come together to create statutory Integrated Care Systems (ICSs) to plan health and care services around patients’ needs. The aim, said the Government, is to move services out of hospitals and into the community, focusing on preventative healthcare.
It said the NHS will only need to tender services when it has the potential to lead to better outcomes for patients.
A ‘package of measures to deliver on specific needs in the social care sector’ is promised. This will, said the Department of Health and Social Care, ‘improve oversight and accountability in the delivery of services through new assurance and data sharing measures in social care, update the legal framework to enable person-centred models of hospital discharge, and introduced improved powers for the Secretary of State to directly make payments to adult social care providers where required’.
The Government said the pandemic has shown the impact of inequalities on public health outcomes and the need for it to act to help level up health across the country. It said legislation will help to support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed.
Cllr Ian Hudspeth said the white paper provides a ‘promising base on which to build stronger working relationships between local government and the NHS, as equal partners, to address the wider determinants of health and deliver better and more coordinated health and care services’.
He said the LGA will be working with councils, the Government and NHS England ‘to better understand the full implications of these wide-ranging proposals’. He welcomed putting ICSs on a statutory footing, ‘and the addition of a truly joint Health and Care Partnership in every system alongside statutory NHS bodies’.
It was ‘helpful the white paper recognises the pressures facing social care and makes clear the Government remains committed to reform, but action is needed and proposals must be brought forward as a matter of urgency’, he continued.
Public health services run by councils had ‘more than proved their worth through the pandemic, as part of the tremendous local response’, he added. He continued: ‘Any centralisation of public health powers would be of clear concern and we hope that further government proposals to be brought forward will build on these strong local foundations.’
He said the LGA was urging government to ‘recognise and build on existing local democratic mechanisms, such as Health and Wellbeing Boards and health overview and scrutiny arrangements. We will be concerned if the powers of local Health Overview and Scrutiny Committees are undermined by giving greater powers to the Secretary of State.’
Ed Garratt, executive lead for the Suffolk and North East Essex Integrated Care System said: ‘I welcome the white paper, as the lead of an Integrated Care System , as it gives clear accountability for the NHS and at a system level formalises shared governance across the NHS, local government and other partners. The proposals will support greater collective effort on improving outcomes for our population, which is the ultimate purpose of our work.’
