NHS Finance

28.07.20

Advisor appointed on proposal for NHS to take over social care

Camilla Cavendish, former Policy Chief under David Cameron’s government, has been appointed by Downing Street to help examine and finalise proposals which would see social care brought under the control of the NHS in England, along with the £22.5bn annual funding budget.

The controversial move, first reported by the Guardian, would see responsibility for social care services shifted away from councils in England and handed to the NHS in an effort to honour a pledge by Prime Minister Boris Johnson to “fix the social care crisis”.

Under the proposed merger, services would be designed to make it easier for frail older people, as well as vulnerable children and the disabled, to access care and reduce pressures on the NHS. Social care has found itself increasingly under a spotlight and beset with problems in recent years, including health inequalities, inconsistent availability of care, workforce shortages and tightening budgets.

However, any proposals would remain contentious and local authorities are likely to push back against the merger, with local government having played a key role in social care provision for decades and it representing a significant source of funding.

Equally, when questioned the Department of Health and Social Care (DHSC) denied it had plans to merge the two public services.

It is understood Ms Cavendish and Helen Whately, the Minister for Care at the DHSC and who is responsible for social care reform, are examining a plan whereby those services would be commissioned by – and their budgets controlled by – through the NHS’ relatively new regional Integrated Care Systems (ICSs).

However, implementing such a change would require legislation to be passed. At present, ICSs – which look to bring together different NHS providers of care within a geographic region – still have no legal standing and are still very much in their embryonic stage of development, having been introduced by current NHS England Chief Executive Sir Simon Stevens.

It had been previously revealed, also by the Guardian, the Prime Minister has contemplated taking back significant control of running the health service from NHS England, a proposal which may include making ICSs legal entities – a move which current Health Secretary Matt Hancock has backed.

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