4 Co-operating generally
This clause requires local authorities and relevant partners, as listed in subsection (5), to co-operate in carrying out their respective functions relevant to care and support. It does not create any new functions, or require the local authority to undertake any particular activities, but there are a number of other existing powers which local authorities may be able to use to promote joint working.
For instance, local authorities may share information with other partners, or provide staff, services or other resources to partners. Under section 75 of the NHS Act 2006, a local authority may contribute to a ‘pooled budget’ with an NHS body, a shared fund out of which payments can be made.
(1) A local authority must co-operate with each of its relevant partners, and each relevant partner must co-operate with the authority, in the exercise of—
(a) their respective functions relating to adults with needs for care and support,
(b) their respective functions relating to carers, and
(c) functions of theirs the exercise of which is relevant to functions within paragraph (a) or (b).
(2) A local authority must co-operate, in the exercise of its functions under this Part, with such other persons as it considers appropriate, being persons who exercise functions, or are engaged in activities, in the authority’s area relating to adults with needs for care and support or relating to carers.
(3) A local authority must make arrangements for ensuring co-operation
between—
(a) the officers of the authority who exercise the authority’s functions relating to adults with needs for care and support or its functions relating to carers,
(b) the officers of the authority who exercise the authority’s functions relating to housing (in so far as the exercise of those functions is relevant to functions referred to in paragraph (a)), and
(c) the Director of Children’s Services at the authority (in so far as the exercise of functions by that officer is relevant to the functions referred to in paragraph (a)).
(4) The duties under subsections (1) to (3) are to be exercised for the following purposes in particular—
(a) promoting the well-being of adults needing care and support and of carers in the authority’s area,
(b) improving the quality of care and support for adults and support for carers provided in the authority’s area (including the outcomes that are achieved from such provision), and
(c) protecting adults with needs for care and support who are
experiencing, or are at risk of, abuse or neglect.
(5) Each of the following is a relevant partner of a local authority—
(a) where the authority is a county council for an area for which there are district councils, each district council;
(b) any local authority, or district council for an area in England for which there is a county council, with which the authority agrees it would be appropriate to co-operate under this section;
(c) each NHS body in the authority’s area;
(d) a local policing body the whole or part of whose area is in the local authority’s area;
(e) the Minister of the Crown exercising functions in relation to prisons, so far as those functions are exercisable in relation to England;
(f) a relevant provider of probation services in the local authority’s area;
(g) such person, or a person of such description, as regulations may specify.
(6) The reference to an NHS body in a local authority’s area is a reference to—
(a) the National Health Service Commissioning Board, so far as its functions are exercisable in relation to the authority’s area,
(b) a clinical commissioning group the whole or part of whose area is in the authority’s area, or
(c) an NHS trust or NHS foundation trust which provides services in the authority’s area.
(7) “Local policing body” has the meaning given by section 101 of the Police Act 1996.
(8) “Prison” has the same meaning as in the Prison Act 1952 (see section 53(1) of that Act).
(9) “Relevant provider of probation services” has the meaning given by section 325 of the Criminal Justice Act 2003.
To the list of partners at paragraph 5 should be added something on the lines of ‘other providers of health services commissioned either by the NHS Commissioning Board or by a clinical commissioning group’ to cover a whole host of independent/third sector/private providers.
I would support John Gooderham’s suggestion – it is important that independent/third sector/private providers are an integral part of the partnership thus dispensing with the ‘us and them’ syndrome.
I am a member of a local Carers Advisory Partnership,but find that it’s very hard work to get the local authority to ACT on concerns raised by carers.We have found that it’s best to talk to the most senior person available, in either the local authority or local NHS Pct.They now call social workers,self directed support practioners,but I have little evidence that they are able to make decisions about the care of service users,without consulting a manager. The whole system needs urgent review and change.
I’m not sure if they are already covered in the draft legislation by the reference to the police, but coperation from coroners can also be an important element when investigating allegations of abuse/neglect.
There is an overall need for all in health and social care to appreciate that carers are their most valuable partners in care and to work together to ensure that carers are supported.
Voluntary sector are partners, should be specified.
One of the failures of the services to people is the failure of provider organisations to interface with each other, consult, share information in an open and transparent manner. This is exaserbated by funding structures.
We welcome both clauses 4 and 5; as things currently stand people, do not always benefit from a joined-up approach by health and social services. For instance, providers of NHS services do not systematically inform patients about the social services available to them; research conducted by Action on Hearing Loss found that, when receiving their hearing aid, 77% of respondents did not receive any information about other equipment that might be useful to them . Such a joined up approach is particularly important where people have complex needs, for instance where someone has hearing loss and dementia. In these types of cases the sharing of information is essential. For instance, diagnostic tests for hearing loss may not be appropriate for someone with dementia; in these types of cases, social care professionals could provide important information as to the type of approach that will work.
Action on Hearing Loss believes that GPs should be included in the list of relevant professionals. GPs and their wider primary care team, including community nurses, often have regular contact with patients and are well-placed to have an overview of both people’s health and social care needs, and any issues around safeguarding. Information that they receive from social services may well have an impact on how they deliver care to patients. Similarly, they may have access to important information that will benefit the quality of care and support offered by social care professionals.
This clause replicates and brings together most existing duties to co-operate found spread amongst NHS and social services legislation at present. But experience from all other areas of ‘mandatory’ co-operation predicts that this is an unenforceable duty that turns wholly on the individuals and culture in place, locally. Also, in this particular era, there are insufficient public sector staff, or too many doing too many people’s jobs, to spend time doing all this ‘talking’ in my view.
I would point out to other consultees that the provider sector, whether voluntary or for profit, are included in this supposed duty in ss2, as ‘other persons’ who are engaged in activities…- they are not partners, in a public sector sense, and would be misled by so thinking into believing that councils would treat them as equals. The last year has shown that providers have been driven to bringing legal proceedings against councils for not genuinely listening to them when they were going on about quality, and the impact of the commissioners’ approach to cutting contractually agreed fees etc; this is despite 10 years worth of exhortation from the leadership of the sector, to treat providers as partners, and to consult with them. So what possible value this clause brings to changing that culture, is obscure to me.
This clause reiterates previous rhetoric on integration of services. Ther needs to be some more positive action to make it happen. Joint and ring-fenced funding may be the only option – otherwise it will always be someone else’s responsibility.
In our experience local authorities need specific instruction in order to cooperate with vountary sector providers such as ourselves, even when we are contracted to provide their services. We do not see how this clause establishes that instruction. The failure to work cooperatively has a detrimental impact on the local authority, people who use the services and the service provider and does not make best use of limited public funds.
Registered Providers of social housing (aka housing associations/RSLs) also need to be listed as partners in clause 5, given case law that they are in some circumstances, ‘public bodies’ and due to their staffs’ fundamental role in detecting and responding to abuse and their potential (often unrealised) role strategically in ‘hot spot’ areas. Many safeguarding partnerships consider, wrongly, that the council housing department is the only housing agency that needs to be involved.
“promoting the well-being of adults”…”improving the quality of care and support” and ” protecting adults at risk” – the Local Authority are not the only ones with these objectives so co-operation between ALL partners would be welcomed but there is a culture change required to see it happen.
We note that whilst there is an explicit focus on wellbeing in clause 1, there is no reference to co-operation with the Health and Wellbeing Board in this clause. We feel that the focus of co-operation should always be on improved outcomes – whether these are at community or individual level.
West Anglia Crossroads on behalf of carers supports the principle of co-operation. We believe Third Sector organistaions should be mentioned specifically in section 5 as partners.
Integrated health and social services are still an aspiration and would have a huge positive mpact. Funding streams often contribute to silo approaches from statutory services eg adult v children v Learning Disability v mental health services …..and carers are affected by all. The option that a local authority may contribute to a ‘pooled budget’ with an NHS body, a shared fund out of which payments can be made would be welcome.
Again, reference to a ‘Duty of Care’ shoud be included in the wording for this part of the legislation.
Sections 4 & 5
We Support the general duty of cooperation of relevant partners but need greater clarity on the opt outs under the specific cooperation duty, particularly when this relates to safeguarding concerns.
All involved parties must co-operate with each other and be open and share relevant information. There needs to be an end of “passing the buck” when issues need sorting. There needs to be “one port of call” to resolve issue. The most important people in the whole process are the Service User and their Carers and ensuring they have good quality care.
The use of the term co-operating is wrong in this context. It implies a weak and loose relationship between the partners. To address increasingly complex problems co-operation should also include effective collaboration and communication between service users, carers and health and social care professionals. Important that the Bill highlights the preparation and support needed for this level of cooperation and collaboration. It is very difficult for organisations and individuals to work in different ways, especially when organisations have very different structures, systems and cultures.
The list of relevant partners needs to include health and social care professionals.
I would echo some of the specific comments above about inclusion of housing providers among those with safeguarding roles (though not necessarily on the SAB) (Parry), about the need for greater clarity on the opt outs to the specific co-operation duty (Flynne and Williams) and on duty of care (Ingram). Our research on serious care reviews covering vulnerable adults (conducted for the DH) suggests that by and large co-operation exists between statutory services at managerial and operational levels but the PCT has often been at the fore of this in Health services. New roles and relationships will need to be forged at local levels which will be aided by clarity in the Bill or Guidance about health services’ duties and the responsibilites of Monitor will need to be described.