Worries over ‘poorer quality’ learning disability support as …

Fears have been raised that adults with learning disabilities could face a “poorer quality” support service if the partnership between Cambridgeshire County Council ^[1] and the Integrated Care Board (ICB) falls apart. The county council has agreed to terminate a shared funding arrangement with the ICB to fund a support service for adults with learning disabilities and their families.

However, the authority said it wanted to continue to work in partnership with the ICB to provide the service, but said the health partners had announced it wanted to fully pull out. Councillor Richard Howitt, chair of the county council adults and health committee ^[2], said he worried this would cause a “poorer quality” of service being provided.

The county council said the Cambridgeshire ^[3] Learning Disability Partnership had been running since 2002 and provides integrated health and social care services to adults over 18 with a learning disability and their families. The county council and the Cambridgeshire and Peterborough ^[4] CCG, now the ICB, had an agreement in place to run the service, including a pooled health and social budget.

A report presented to the county council adults and health committee meeting this week (October 5) said the current £122million budget for the shared service was split with £93.7million provided by the county council and £28.3million provided by the ICB. The report said following an independent review of the arrangement, the county council looked to reach a new negotiated settlement with the ICB.

However, at the meeting this week (October 5), officers said this agreement looked unlikely and therefore the funding arrangement was proposed to be terminated from August next year. The report said: “The agreement does not appear to be operating in the way it was originally intended. Significantly, the governance arrangements specified in the agreement are not being fulfilled which presents a significant governance risk to the council and does not accord with the way in which the agreement is intended to operate.

“This means that the council is unable to mitigate financial risk and no appropriate mechanism exists for resolving issues such as the financial contributions which has left the council at a disadvantage, which is unsustainable. There has been no progress in revising the risk share arrangement in a timely manner. This means the council is carrying significant financial risk and cannot invest its resources fully to support people with social care requirements.”

Cllr Howitt said the county council had only wanted to end the pooled budget, and to carry on the shared service, but said the ICB had announced it wanted to end the whole partnership. He said: “I find it breathtaking that you have senior people, skilled, mature people from both sides who spent, to my knowledge I accept it is longer, a year and a half sitting in rooms together and have been unable to first agree a fair cost sharing arrangement and then even to be able to agree a mediator or adjudicator to do it.

“I just find that astonishing and deeply sad that that has not been able to happen, it certainly is not within the spirit of partnership working. What is also deeply sad is in the letter we got it was said well we are going to withdraw from integrated management of the service.

“We said we will withdraw from the joint cost sharing arrangement, which essentially would mean more work by finance people on both sides, but we wanted to carry on providing an integrated service, which is better for the service users, that is what we said and they have said no they will not agree to that.

“We hope they can be persuaded to change their mind on it. I do believe if they do withdraw from the integrated service there will be a poorer quality of service and that is why I think the next phase of this is us advocating very strongly with our health partners that they should not go through with that threat.”

References

^{^} Cambridgeshire County Council (www.cambridge-news.co.uk)
^{^} adults and health committee (cambridgeshire.cmis.uk.com)
^{^} Cambridgeshire (www.cambridge-news.co.uk)
^{^} Peterborough (www.cambridge-news.co.uk)
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