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Editorial

Editorial Peter Thistlethwaite EDITOR At the beginning of the decade, an innovative the arrangement to deliver the NHS goals, and integrated structure brought health and social care ultimately caused it to end. Look at Wiltshire, too; services together in the London Borough of Barking here one of the most prominent and enthusiastic and Dagenham under a single leader. There was a early adopters of integration has suffered a similar good deal of national attention paid to this fate after three years of an ambitious s31 arrangement, and considerable surprise when it partnership which created integrated community came to an end after about two years. Gerald teams across the county. The villain here appears to Wistow and Eileen Waddington give their analysis be the dire NHS financial crisis in the region. of what happened in a key article in this Issue. Messages: people revert to (NHS or local As Editor, I was struck by one short sentence in authority) type when under pressure, and Wistow their article: A care trust, however, would not have been and Waddington are right to suspect that disestablished. This unambiguous conclusion integration will only be secured when a very deserves a little extra consideration here. The most searching process to establish partnerships is in obvious implication is that a locally determined place, and when central government functions are partnership will be less robust than one which has themselves integrated. In a telling comment in gone through the crucible of the formal DoH their article, one local interviewee said ‘there are no process to grant the new statutory status which a stars for integration’, which may be one of the care trust has. Where does this leave partnership reasons that most localities are cautious about the developments in Southwark, Peterborough and scope of their investment in integration. Knowsley? If all this is so, why was it not dealt with openly This journal’s focus on integrated care is in the recent White Paper, and the bullet not predicated on the belief that there is evidence that bitten? The lack of exploration of barriers to consumers can experience real benefits from close partnership, and of what might make any new collaborative working. It is also why the partnership more sustainable, is to be deplored. Government promotes it. The lack of any initial Without it, the risks of failing to deliver the best clarity or agreement about the user benefits being possible quality and efficiency to service users will sought is put forward by Wistow and Waddington remain. as a key weakness in the project in Barking and Simple common sense would suggest that the Dagenham. But, as they go on to demonstrate, the creation of a single organisation with the delegated Government’s own regulators and performance power to control its own vision, resources and managers are not integrated, and instinctively decision-making would instinctively try to pull apply pressures for local bodies to conform to together in a time of crisis, rather than pull apart. separate health and social care standards. It appears This does not have to be a care trust, but it does that one of these (the SHA) had no confidence in have to have the same sort of coherence. 2 Journal of Integrated Care Volume 14 • Issue 3 • June 2006 © Pavilion Publishing (Brighton) Ltd http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Integrated Care Emerald Publishing

Editorial

Thistlethwaite, Peter
Journal of Integrated Care , Volume 14 (3): 1 – Jun 1, 2006
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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
1476-9018
DOI
10.1108/14769018200600017
Publisher site
See Article on Publisher Site

Abstract

Peter Thistlethwaite EDITOR At the beginning of the decade, an innovative the arrangement to deliver the NHS goals, and integrated structure brought health and social care ultimately caused it to end. Look at Wiltshire, too; services together in the London Borough of Barking here one of the most prominent and enthusiastic and Dagenham under a single leader. There was a early adopters of integration has suffered a similar good deal of national attention paid to this fate after three years of an ambitious s31 arrangement, and considerable surprise when it partnership which created integrated community came to an end after about two years. Gerald teams across the county. The villain here appears to Wistow and Eileen Waddington give their analysis be the dire NHS financial crisis in the region. of what happened in a key article in this Issue. Messages: people revert to (NHS or local As Editor, I was struck by one short sentence in authority) type when under pressure, and Wistow their article: A care trust, however, would not have been and Waddington are right to suspect that disestablished. This unambiguous conclusion integration will only be secured when a very deserves a little extra consideration here. The most searching process to establish partnerships is in obvious implication is that a locally determined place, and when central government functions are partnership will be less robust than one which has themselves integrated. In a telling comment in gone through the crucible of the formal DoH their article, one local interviewee said ‘there are no process to grant the new statutory status which a stars for integration’, which may be one of the care trust has. Where does this leave partnership reasons that most localities are cautious about the developments in Southwark, Peterborough and scope of their investment in integration. Knowsley? If all this is so, why was it not dealt with openly This journal’s focus on integrated care is in the recent White Paper, and the bullet not predicated on the belief that there is evidence that bitten? The lack of exploration of barriers to consumers can experience real benefits from close partnership, and of what might make any new collaborative working. It is also why the partnership more sustainable, is to be deplored. Government promotes it. The lack of any initial Without it, the risks of failing to deliver the best clarity or agreement about the user benefits being possible quality and efficiency to service users will sought is put forward by Wistow and Waddington remain. as a key weakness in the project in Barking and Simple common sense would suggest that the Dagenham. But, as they go on to demonstrate, the creation of a single organisation with the delegated Government’s own regulators and performance power to control its own vision, resources and managers are not integrated, and instinctively decision-making would instinctively try to pull apply pressures for local bodies to conform to together in a time of crisis, rather than pull apart. separate health and social care standards. It appears This does not have to be a care trust, but it does that one of these (the SHA) had no confidence in have to have the same sort of coherence. 2 Journal of Integrated Care Volume 14 • Issue 3 • June 2006 © Pavilion Publishing (Brighton) Ltd

Journal

Journal of Integrated Care – Emerald Publishing

Published: Jun 1, 2006

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