Ambitious plans for health and social care services
The NHS Long Term Plan has set out an ambitious vision for the development of the health services over the next 10 years.
When it was launched in January this year there was a great deal of debate about how best to deliver it, and that it could not succeed in isolation from other agencies.
This is especially true in the relationship with social work, public health, social care and housing that are part of local authorities’ commissioned services.
As NHS England (NHSE) moves towards designing the implementation stage of the plan, an important part of this process is to identify where the responsibilities of local authorities need to be involved and where social work can make a difference.
In some cases, the LTP cannot successfully be delivered without LA social care and public health services working alongside the NHS.
Joining the dots
The lack of a distinctive joined up NHS and social care Long Term Plan does not stop us from working in constructive partnership and redesigning our services around people’s needs.
In mental health services, the chief social workers office, the LGA and the association of directors of adult social services have been working with the NHSE adult MH team, to take every one of the ambitions in the LTP and examine the way it could work with social care.
As an example, the LTP makes a very positive commitment to supporting people into employment.
We have worked with NHSE to identify local authorities already commissioning and supporting employment services. This includes supporting flexible commissioning and integrated working.
These elements might be needed to link these projects with NHSE funded individual placements and support developments to make then all more effective.
Continuous care through the ages
Another example is transition services for young people moving from children’s services to adults. This is a welcome addition to the NHS Plan. Local Authorities have a major role in this area as commissioners and providers of services.
Young people might be in special educational establishments or be looked after children. They may also be in Child and Adolescent mental health services – or a mixture of all of these. Transitions often involve a complex array of different services and professionals all working together with the young person at the centre and joint working is essential.
The LTP has prioritised new resources and ideas into developing a core community mental health services framework based on a model that sees a prevention, integration and a community asset based approach as vital. Everyone involved in this process valued the social determinants of health as a core part of the model.
The challenge is to reduce the barriers between primary and secondary care, social care, voluntary, independent and housing providers so that people can access these services and move between them easily. ADASS has been briefed on this model and each region will be expected to involve social care, VCS and public health bodies in implementing it.
Choice and control of our care
The new comprehensive model for personalised care and health budgets has been designed in partnership with the Local Government Association and Think Local Act Personal.
This has an underlying philosophy and values of choice and control over care and support that will be familiar to social workers. This model, like the CMH framework above, links to the rights within the Care Act 2014 and s117 aftercare under the mental health act.
Another important issue in the LTP is workforce – where the NHS is looking to fill vacant posts and to develop new skills to meet the LTP challenge.
An important part of this is the valuable contribution EU nationals make to the social care and NHS workforce. Both the Government and the LTP have committed to supporting and encouraging those from beyond our shores who live, train and work here to continue to do so, regardless of the manner of our exit from the EU.
Retaining staff in uncertain times
The recently launched EU Settlement Scheme and new legislation guaranteeing mutual recognition of professional qualifications (MRPQs) beyond our departure should provide strong reassurance and incentives to remain for those health and social care workers who have made this country their home.
We have been working with Health Education England's new roles development group to examine how social work can be part of the NHS workforce and where new social work roles and opportunities are needed.
These examples show that we have an opportunity to develop positive partnerships between the ambitions of the Long Term Plan and the responsibilities of local authorities and the skills of social work.
About Mark
Mark Trewin is Mental Health Social Work Lead at the Department of Health and Social Care