To make proposals for the development of high-performing health and social care services by 2012 to meet the expected future needs of 18-64 year-olds in Herefordshire with mental health problems and physical disabilities, having regard to the views expressed on the proposals by the Adult Social Care and Strategic Housing Scrutiny Committee and the Health Scrutiny Committee.

THAT  (a)   the proposed patterns of high-performing mental health and physical disability services be approved and put in place between April 2008 and March 2012;

(b)               these should be achieved by means of detailed joint commissioning plans of the Council and the Herefordshire Primary Care Trust;

(c)  the adequacy of the new patterns of services should be subject to a further full review of needs and services by 2012 in the light of better data and of actual demand for modernised services;

(d)               the results of the review be used to inform budget planning at that time; and

(e)               The Adult Social Care and Strategic Housing Scrutiny Committee and the Health Scrutiny Committees other resolutions will be taken into account in the course of implementing the new patterns of services.

Notwithstanding additional investment in recent years and some improvements, in important respects Herefordshire’s services formental health and physical disability are not performing as well or as efficiently as those in a number of comparable parts of the country; neither do they provide a sound or sustainable basis for meeting future needs.

The Council’s current 1* Commission for Social Care Inspectorate rating for Adult Social Care and the PCT’s “Fair” services rating from the Health Care Commission constrain alternative options. In short, unless services are modernised and significantly improved, those ratings would be likely to deteriorate, with damaging consequences for the reputation of both bodies.  This would be happening at the same time as the Council and the PCT are seeking to make a success of much closer joint working, under a single chief executive and joint management team, to achieve better services and outcomes for users.

Making the changes over a longer time-span would be a false economy, since not only would costly, inefficient and ineffective elements of services continue for longer but also there would be a danger that a lengthier period of inadequately developed local services would result in even greater use of inappropriate residential and out-of-county care and, therefore, even greater spending pressure against budgets.

There are, therefore, no alternative options.