‘Radical’ revamp of health and social care in Peterborough and Cambridgeshire recommended in landmark report

An independent report commissioned by metro mayor James Palmer calls for “radical integration” of health and care within the county which would see the joining up of various organisations and budgets.

The recommendation follows a two-year review by the Cambridgeshire and Peterborough Independent Commission on Public Service Reform which takes into account the coronavirus pandemic.

The commission calls for health to be put “at the heart of every decision” and calls for the Government to place decision-making powers into the hands of local officials.

It is also recommended that the Cambridgeshire and Peterborough Combined Authority - the mayoral body led by Mayor Palmer - submits a devolution bid to the government.

Mayor Palmer said he welcomed the findings but that it would be “sensible to consider further, including in particular awaiting a recovery from the current renewed Covid pandemic, before deciding a way forward on issues relating to health and care services”.

The commission chaired by Dr Andy Wood argues that devolution would “hugely accelerate progress” and could “make the difference between an agenda that simply improves the health of its population and one that becomes an example for a totally new way of approaching public health”.

Under its preferred model, there would be a pooled budget for health and social care in the region, with funding then devolved to local councils, allowing a greater focus on prevention strategies which would provide long term benefits as well as “significant financial savings”.

Cambridgeshire and Peterborough would also be able to create its own strategy, rather than focus on government priorities, with its own organisational structure separate from Whitehall diktat.

However, the commission warned against concentrating powers in the hands of an “overarching body” such as the combined authority, stressing that “devolution from central government must be done in order to further devolve power and responsibility ‘down’ to the frontline, to organisations that work within the community”.

Responsibility for health care locally is split among different organisations; the commissioning of services is done by the clinical commissioning group (CCG), with money transferred through to networks of GPs and health trusts.

Public health is the responsibility of local councils.

The commission argues that bringing organisations together would be “relatively administratively easy, and it would in theory be easy to see short-term improvements in efficiencies”.

It also says there is “potential to be more ambitious and creative” with funding for social care, with ideas including a care tax or reducing council tax for families taking care of elderly relatives in their homes.

The full devolution of responsibility for health and social care budgets and services has happened in Greater Manchester and London.

The combined authority - which was formed in 2017 as part of a devolution deal which saw it handed powers over transport, housing, adult education and growth - has no role in health across Cambridgeshire and Peterborough.

However, under the deal agreed with the Government, it said it committed to transforming public service delivery and has since decided to focus its attention on health.

Dr Wood said: “Our focus as independent commissioners has been on how the combined authority and all its partners and stakeholders might best contribute to improving health and wellbeing across the entire population that it exists to serve - our hope is that this report will ensure that we put health at the heart of every decision.”

The full report can be read at: https://cambridgeshirepeterborough-ca.gov.uk/assets/Uploads/21801-CP-full-report-v5.pdf.