The state of Cornwall’s Health & Social Care
The state of Cornwall’s Health & Social Care; the blog post that needs writing but I don’t know where to begin and how the story will end!
Like Andrew George, I have been consistent and clear that our NHS needs more Government funding or it will just fall over. That is not to say that there isn’t room for improvement or that some efficiency savings could not be made, by working differently within our local health services and by better collaboration with the Council’s social care provision. The trouble with just looking at re-organising, whether top down or bottom up, at least in the short term, it would require more not less money; and everything I’ve seen is driven by the Government wanting to reduce what we spend on health and social care. There is also the matter of rising demands as our local population ages and recruiting and retaining staff, whether nurses, GP’s or home care workers.
“The Care Quality Commission has called on leaders of the organisations that oversee the provision of health and social care in Cornwall to join forces and work together to ensure that people get the services they need as they move through the system.” (Care Quality Commission website 5 October 2017)
So, things are well and truly back in the spot light because of critical Care Quality Commission (CQC) reports. The summary of the CQC report on the Royal Cornwall Hospital Trust can be read here. A wider report, looking at health and social care was also critical of how services work together and I agree with the headline in that report that Leaders need to “re-focus on the needs of people moving between services“. The key recommendations from that report are worth giving in full so they are below.
This report identifies five areas for improvement:
- “The system leaders must focus on building and presenting a cohesive, visible leadership team with a full time leader to take forward the sustainability and transformation plans.
- Arrangements for interagency working must be clarified, strengthened, and consistently implemented. System leaders responsible for commissioning and delivering care should set out and communicate widely their agreed framework, structure and governance
- Leaders must re-engage with the community and staff and establish a programme of co-production across the area to better understand the problems, and involve staff and public to agree on priorities.
- There is an urgent need to refocus on the experience of people moving between services who need ongoing support.
- All recommendations must have an accountable person or group to oversee action, implementation, monitoring and evaluation.”
Unhelpfully, in my opinion, NHS England has put in the public domain their suggestion that Cornwall Council should take over Health Commissioning from the Clinical Commissioning Group. Whilst discussions about closer working and joint commissioning have been on the table the suggestion that Cornwall Council should commission all health services leaves me a little mystified and needs much more examination over whether that is desirable, likely to work and, most importantly, has the potential to improve things.
Being in the Cabinet now, I want to assure everyone reading this that I and your other 9 Cabinet Members will be giving this very careful consideration and will not be making decisions in haste, no matter what the Government might want! Red lines will have to be part of any deal and money will have to come into Cornwall to improve the situation. I will not be part of any plan to re-organise the deck chairs on the titanic!