Integrated Care in Salford A UNISON Report Compiled by Salford City UNISON and Salford Health UNISON

Background In late 2014, Salford City Council informed its recognised trade unions that discussions were underway to create an “Integrated Care Organisation”. The intention was to transfer the City Council’s adult social care services into Salford Royal NHS Foundation Trust and to integrate them with SRFT’s Community Health services. Rationale of integrated health and social care: less duplication – cost savings and joined-up care greater investment into preventative services, largely based in the community.

A Simplified Model of Salford’s Adult Health & Social Care System (1): Pre-ICO COMMISSIONER PROVIDER GM West Mental Health Salford Clinical Commissioning Group (CCG) Salford Royal FT Acute Community Salford City Council Social work Private / CVS Social care

A Simplified Model of Salford’s Adult Health & Social Care System (2): With ICO COMMISSIONER PROVIDER GM West Mental Health Salford Clinical Commissioning Group (CCG) Salford Royal FT Acute Community Integrated Care Organisation (ICO) – a division of SRFT Salford City Council Social work Private / CVS Social care

Accountability of the ICO? Council remains initial commissioner of social care services. Councillors sit on ICO board. However, does even this give leaders of unelected NHS Trust too much power, given 5 year + 5 year contract? How do we protect services and advocate for ethical commissioning?

Process City Council staff were engaged in a robust consultation exercise, BUT decision had already been taken that SRFT would host. SRFT staff hardly consulted at all. Staff groups kept separate for a long time.

Employment Issues: TUPE? Public to public transfer? They say YES, we say NO. Solution – Get everything in collective agreement 

Employment Issues: Non-TUPE Ts and Cs Pensions  - SRFT applied for and got LGPS Admitted Body Status Cost of living awards  - SRFT agreed to apply NJC Pay Awards Continuous service  - Redundancy Modification Order an Obstacle. Does GM Devo have the answer? New starters??? – NJC? Local or National? A4C?

Post- Transfer Issues ICO set up on 1st July 2016 Different terms & conditions for staff doing the same job Examples of the employment complexities of integrating services: Continuity of service Job evaluation

(1) Continuity of Service For formerly Council-employed staff Continuity of service protected if change employer within the NHS But other social work staff are employed by Councils – more likely that they would move to a LG employer Not clear if continuity of service applies if move from Health back to LG

(2) Job Evaluation Job Evaluation Profiling LG jobs to be converted into Agenda for Change pay scales Social work jobs are difficult to match to national AfC job profiles LG job descriptions require much less in regard to essential education AfC scores jobs on 16 factors Points awarded determine the banding of the job

AfC Job Evaluation: Scoring Chart

AfC Job Evaluation: Band ranges

Job Evaluation Concerns post-transfer Where other areas pursue integrated care models - danger of same job being banded differently From national profiles to local profiles? Better if social work job descriptions were profiled at a national level into the AfC Profiling System