Cornwall set to win 'NHS devolution' deal

Cornwall is set to win its own ‘NHS devolution’ deal, which could see the county take control of a £2bn combined health, care and welfare budget by the end of the decade, according to reports.

The deal would see Cornwall follow Greater Manchester as the second English region to bring its NHS and council-funded care services together under one budget, controlled by council and local health authorities.

Although details of the plan are still to be finalised, the Health Service Journal (HSJ) and the Local Government Chronicle (LGC) reported that the Chancellor George Osborne will announce a new deal for Cornwall in next week’s Budget.

Integrating health and social care is central to the Government’s future plans for the NHS.

With a growing elderly population who are dependent upon both the NHS and their local council for long-term care, the historic separation between the two sectors is seen to be holding back effective, joined-up care between the home and the hospital.

Scotland has already legislated for councils and local NHS boards to pool their health and care budgets. In England, a deal announced in February to hand a £6bn health and care budget over to local councils and NHS bodies in Greater Manchester, was seen as firing the starting gun for wider reform. Some smaller local areas already have forms of integration place.

While the DevoManc plans have attracted support, and national care and access standards will still apply, some raised concerns that spitting the NHS into regional fiefdoms could lead to the ‘Balkanisation’ of the health service.

According to the HSJ and LGC, citing senior sources familiar with discussions, the Cornish deal will see health and social care services jointly commissioned by the GP-led Kernow Clinical Commissioning Group and Cornwall Council.

Under plans set out in a Cornish council paper, budgets will be pooled by 2020, and the area will also consider including welfare spending, which would bring the joint spending pot to £2bn. The changes would begin to come into effect by April 2016.

The Royal Cornwall Hospitals Trust and the Cornwall Partnership Foundation Trust, which delivers mental health services, are already in merger talks.

It is understood the devolution of transport powers are also under serious discussion. However, the HSJ reported that NHS England does not at present intend to delegate budgets for certain specialist health services, which it controls centrally, to Cornwall.

A Treasury spokesperson said the Government could make no comment in advance of Wednesday’s Budget announcement.

Cornwall Council leader John Pollard said: “For some weeks and months we have been preparing a ‘Case for Cornwall’ which are the things we think Cornwall could benefit from having. We have been discussing those with officials and civil servants and those discussions continue.”