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A new care trust in Blackburn is bringing together the commissioning budgets for primary care and children's and adult health. Graham Burgess describes its progress Seeking excellence, improving the lives of local people, leading locally, regionally and nationally... these are just some of the visions and values from NHS trusts across the UK and, as readers will guess, they could quite easily be attributed to a plethora of public sector organisations, including councils, police forces and colleges. It is with this in mind, as well as the pending financial squeeze, that councils have an opportunity to lead the way forward on shared delivery and leadership to meet our financial responsibilities, as well as take our rightful place in leading from the front and showing the role the public sector has in improving the lives of people living in our towns and cities. Blackburn with Darwen Council has a proud history of partnership, working with Capita, Bolton MBC – through our Building Schools for the Future programme – and across Pennine Lancashire with our multi-area agreement. Now, we have taken this one step further, and launched our new Care Trust Plus, which brings together the commissioning budgets for primary care and children, and adult health – a combined spend of more than £300m which, linked to the council's budget, equates to £800m of public sector muscle being invested in our borough each year. Uniquely, we have brought democratic accountability to the joint governance arrangements, with three serving councillors on the new board. It isn't going to be easy. The cultures of local government and the NHS are, understandably, quite different. Councils are immersed in local politics and issues, and accountable to locally-elected representatives. Meanwhile, the NHS, as a key political issue nationally, finds itself under pressure from Whitehall mandarins and politicians – all expecting evidence of improvement to back up the investment which has been made. However, despite this, the CAA and, more to the point, Total Place, bring us firmly together, as we are expected to be totally synergised in tackling the issues we face, such as deprivation and health inequalities. The Government has already realised, through its investment in public health, that improving people's wellbeing is impossible, if we do not tackle other factors linked to poor health, such as housing quality, skills, wage levels and road safety. So, while to some, the gulf between the NHS and local government may seem wide, it is, in fact, relatively small when we are both pursuing similar outcomes. This brings us back to how councils are going to meet the challenges we face. The National Institute for Economic and Social Research warned the budget deficit would not be brought down purely by making savings in the public sector. It will be aware that the last few years have seen local government become one of the leanest, most efficient sectors, and any wholesale reductions on funding will have an impact on frontline services, unless we can look at other ways of reducing costs. And that is where we need to be proactive in meeting the challenge head on, and use our synergy with other sectors to our advantage. In Blackburn with Darwen, we are tackling this challenge on a range of fronts, but to a shared set of principles, including: v l in health and social care, our Care Trust Plus not only aligns the commissioning of health across both organisations, but also has a clear remit to explore deeper partnerships, including shared services l our local public service board has launched a series of initiatives, including a ‘systems review' of the public sector which will seize short-term opportunities, and a ‘Think family' programme of collaborative and investment which will mitigate future service demand and negative consequences for residents l we are also doing something similar with our colleagues in Pennine Lancashire, as we explore collaborative working across a host of services, including design and print procurement, building control and community cohesion. As with many other high-performing areas, we have been working closely with public sector partners on projects for years, so the concept of partnership working is nothing new. However, as we are faced with the kind of financial challenges not faced by our generation before, and in a sector that has already trimmed most of the fat through year-on-year efficiency targets, we need to take this one step further by looking at greater collaborative working, not just within local government but across the public sector. This is why we have been proactive in positioning Blackburn with Darwen as a potential contender for ‘single offer' status in April 2011, aligning our partnership initiatives within a coherent programme which combines performance, investment and retention of efficiencies within the area. Clearly, it will be a massive challenge to do this, keep staff on board and offer the kind of efficiencies required by the Government, but it is a challenge we should be eager to grasp. If we are serious about loosening the grip of Whitehall and showing we are ready to adopt the principles of Total Place, we need to be ready to show that we are more than capable of working across the public sector, collaborating on service delivery and adopting smarter, more efficient procurement processes. Only by doing this can we make clear our sector's contribution to easing the country ‘s financial burden, while, at the same time, continuing to deliver high-quality services to our communities. Graham Burgess is chief executive of Blackburn with Darwen Council

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WHITEHALL

All under one roof

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