1. Legal Challenges of Health and Social Care Integration – Does the Care Act Assist? by Léonie Cowen Legal Challenges of Health and Social Care Integration – Does the Care Act Assist? by Léonie Cowen © Léonie Cowen & Associates

2. THE THEMES Different Duties and Geographic Boundaries Care Act and Legislative Changes Legal Basis of Integration – s.75 or what? Employees – Ts & Cs and Pensions; Solutions – New governance models? © Léonie Cowen & Associates 1

3. DIFFERENT DUTIES AND GEOGRAPHIC BOUNDARIES National Health Service v Local Government Health - free at the point of delivery but many local authority services paid for by users Fundamentally different legal basis, funding and governance © Léonie Cowen & Associates 2

4. CARE ACT 2014 The Act reforms the law relating to care and support for adults and carers in England Mostly in force now S.1 general duty to promote individual well-being Promoting integration of care and support with health services © Léonie Cowen & Associates 3

5. CARE ACT IN CONTEXT Health and Social Care Act 2012 restructured health care - appointment of Directors of Public Health and Health and Wellbeing Boards Local Authority (Goods and Services Act) 1970 © Léonie Cowen & Associates 4

6. Social Services and Well-being (Wales) Act 2014 To be implemented in Wales in April 2016 in whole or in part © Léonie Cowen & Associates 5

7. NATIONAL HEALTH SERVICE ACT 2006 (1) S.75 health and social care partnerships S.76 payments by local authorities to health bodies and s.256 payments by health bodies to local authorities S.82 Co-operation between local government and health bodies © Léonie Cowen & Associates 6

8. NATIONAL HEALTH SERVICE ACT 2006 (2) NHS Bodies and Local Authorities Partnership Arrangements 2000 (as amended) and the various circulars on vouchers Proposed 2015 regulations not yet laid before Parliament © Léonie Cowen & Associates 7

9. TERMS & CONDITIONS AND PENSIONS Different terms and conditions Local government Pension Scheme Regulations 2013 v NHS Pension Scheme 2015 Application of TUPE Difficulties with secondment © Léonie Cowen & Associates 8

10. PUBLIC PROCUREMENT REGIME Public Contracts Regulations 2015 applies to local government procurements and NHS procurements from 1 April 2015 Contracts between local government and NHS bodies are subject to the public procurement regime © Léonie Cowen & Associates 9

11. SOLUTIONS - NEW GOVERNANCE MODELS? Care Trust – see S.77 NHS Act 2006 Local authority controlled company is not applicable © Léonie Cowen & Associates 10

12. CONCLUSION AND NEXT STEPS True integration is not possible without integrating the services Is greater partnership working achievable with two such different sets of structures, governance and funding? © Léonie Cowen & Associates 11

13. © Léonie Cowen & Associates 12 Leonie Cowen & Associates 3a Loveridge Mews, London NW6 2DP Telephone: 020 7604 5870 E-mail: admin@lcowen.co.uk www.lcowen.co.uk