By Debbie le Quesne

Culture clash alert of single pot care funding

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In recent months there has been much said about ‘joined-up’ delivery – and funding – for care.

Social care and the NHS are currently funded separately, but there’s a deal of political will to change all of that with both disciplines being paid for from one pot.

There are critics aplenty, so I was not surprised to read today that a leading expert in elderly care in Scotland is warning of a culture clash over the merger.

The Scottish government is keen to improve its care of frail pensioners in the community, to prevent hospital admissions and ensure efficient discharge arrangements from wards.

Integrating the NHS and social work departments is the major steps Scots are taking in an attempt to progress the situation.

But all is not sweetness and light.

Professor Paul Knight, president of the British Geriatrics Society and a consultant in elderly medicine at Glasgow Royal Infirmary, says in The Herald there are tensions between the two sides – particularly over money.

Noting NHS budgets had been protected from cuts, but not council funding, he said: “There is a suspicion in health that social care will dump all their large budget deficits on to health and I am sure the reverse will be true (for them).”

The real issues here is money management and who finally will hold the purse strings.

Professor Knight pointed at previous attempts to merge health and social care that ran into difficulties. One example is Glasgow’s Community Health Care Partnerships, which collapsed when the city council voted against committing £400m to the scheme upfront, despite having previously agreed to devolve its entire budget.

I would sincerely hope the funding issues in England would be less tense, but I remain deeply skeptical.

My overwhelming concern is how such funding changes will impact on those who need to sue the service. Integrated partnerships must primarily work for the good of the people they serve . . . dream on Debbie!

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