The way forward for joint working? Involving primary care in the commissioning of social care services

Abstract

This article explores the different ways in which GPs and the primary health care team (PHCT) are involved in working together with social services in the planning, commissioning and purchasing of social care services for individuals or groups of patients in the UK. Seven sites were identified following a literature search of mainstream and ‘grey’ joint commissioning literature. Interviews were carried out with key stakeholders from health and social care purchasing agencies in each site, describing the organisation of primary care involvement in commissioning social care services. The level of involvement in commissioning services varied according to the model of commissioning adopted by the sites. Locality/area-based commissioning offered the PHCT the opportunity to be involved in the strategic planning of health and social care. Practice-based commissioning offered the PHCT the opportunity to commission specific services for their practice population. Commissioning for individuals widened the skills base of the PHCT, by including care management in the services provided by the team. Improvements in interprofessional working between primary health and social services staff were reported in all seven sites; although this did not necessarily extend to front-line staff in the locality model. Service developments were possible in both the locality and practice models, but the potential was severely limited in the individual model. Evaluation of the cost-effectiveness of these models, and the outcomes of these models for service users and carers is urgently needed.