Cornishman Article April 2018

Last month we reported that Cornwall Council with our local NHS organisations had agreed to set up an Accountable Care System (ACS) to be officially launched on April 1st, with plans to go live in April 2019. This would eventually be responsible for running Cornwall’s Health and Social Care services. What is driving this initiative is the ‘threat’ of reduced funding from NHS England if Cornwall does not conform to the national plans.

The first part of this system, a ‘commissioning arm’, came before Cornwall Council Cabinet on the 28th March with a recommendation for approval that was different from the original Overview and Scrutiny Panel recommendation. This change had caused consternation, with some councillors blaming the change on ‘far left wing’ protestors. West Cornwall HealthWatch, which is totally independent of party politics, finds it worrying that health campaigners of any political persuasion can be vilified for carrying out their democratic right to lobby councillors and ask questions of largely unaccountable health organisations.

The Cabinet voted (but not unanimously) to accept a recommendation which includes being a partner with the NHS in developing integrated strategic commissioning (ISC) for health and social care, keeping shared leadership, not to take on any NHS debt, and to use the Council’s Health and Wellbeing Board to oversee the approach. This went against their Overview and Scrutiny Panel findings to set up a new ‘vehicle’ to run the ACS, and differs from the NHS Kernow recommendation. There was no mention of aligning/integrating budgets and it was suggested that ISC can’t begin until the ‘Shaping our Future’ plan for provision of services is made public –we wait and wait!

We seem to have arrived at a point where the public find it hardto work out what is happening whilst many councillors are not really clear what they have voted for, or if and when it will happen?

So, it was a breath of fresh air to attend West Cornwall HealthWatch’s AGM two weeks ago. Thirty plus people listened to Journalist Graham Smith, Councillor Loveday Jenkin and a speaker from WCHW, give their take on ‘Integration, Transformation or Consternation’, followed  by a wide-ranging discussion. It was pointed out that twenty years of initiatives for integrated working have not worked with the main barriers being that the NHS is free at the point of need, whereas social care is means tested; the NHS is accountable to NHS England, Cornwall Council is accountable to their electorate; and there is no common IT system.  Overwhelmingly, the meeting agreed that more funding was required and too much time and energy was being spent on reorganising structures and changing titles, when the focus should be on improving services for patients and carers.  

451 words Copyrighted to WCHW.

Jane Varker, Jan Williams and Marna Blundy