GPs to arrange coordination of health and social care? Pfft. (Updated)

I’ve just read that under the new GP contracts for 2014/15, it is being suggested

GPs will oversee social care for vulnerable patients… Family doctors will “case manage proactively” patients with complex needs by developing and regularly reviewing personalised care plans that will cover health and social care needs.

As always, there are details to be worked out – not least of which is who actually does the care co-ordination. Nevertheless, let’s not allow details to stand in the way of some reflections:

• The options of who does care co-ordination aren’t just within statutory services. There’s pretty good evidence (see, for example, this from the Office for Disability Issues on independent Support, Advocacy and Brokerage) that the best care co-ordination happens outside health and social care organisations in the public sector
• This isn’t integration: this is health taking over social care. Goodness knows there are issues and problems in social care, but I’d suggest more learning about coordination and person-centred approaches can flow from social care to health than vice versa
• If the Secretary of State really thinks this is about “fixing the long-term pressures on our A&E services, empowering hard-working doctors and improving care for those with the greatest need” then he’s (1) motivated by the wrong things at the wrong end of the system, (2) empowering the wrong people, and (3) putting last those people who should be put first.

This stuff is soggy trifle.

Update (22 November): Mithran over at Community Care does a nice summary of the findings of some research on GPs and social workers working together. The full research is here (pdf) – great study through those lovely folks at the School for Social Care Research.

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