New conversations between old players? The relationship between general practice and social care in an era of clinical commissioning

Glasby J, Miller R

Journal of Integrated Care , 23, 2: 42—52

Abstract

Purpose

– With the advent of Clinical Commissioning Groups, the English health system has abolished more managerially led Primary Care Trusts and given greater responsibilities to groups of local general practitioners (GPs). As with all major changes, this brings both opportunities and risks, and the authors know relatively little about what impact this might have on relationships between the NHS and local government. Against this background, the purpose of this paper is to report key findings from a scoping review commissioned by the National Institute of Health Research School for Social Care Research in order to summarise learning from recent literature.

Design/methodology/approach
– The paper is based on a review of the literature on older people’s services and the relationship between general practice and adult social care, published in the UK from 2000 onwards.

Findings
– Despite the longstanding nature of the issues at stake, the review identified only nine relevant studies. These were of mixed quality, and tended to focus on lessons learned from the late 1990s/early 2000s rather than more recent reforms. Overall, these studies suggest similar barriers to those identified in previous policy contexts, and there is a strong sense of relationships starting from a low base (hence the title of our title of “new conversations between old players”).

Research limitations/implications
– This review is based on literature on older people’s services published since 2000 – so only provides a snapshot of the issues at stake. However, it confirms the relatively limited nature of the evidence base and the need for new research to help shape future policy and practice.
Originality/value
– Despite the central contribution of GPs, the authors still know relatively little about the relationship between general practice and adult social care. Reviewing previous literature (however, limited) is crucial to current attempts to develop more effective joint working at local level.