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

2. 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.

3. 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

4. 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

5. 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?

6. 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.

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

8. 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?

9. 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

10. (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

11. (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

12. AfC Job Evaluation: Scoring Chart

13. AfC Job Evaluation: Band ranges

14. 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