‘Breathtaking’ failure to agree cost-sharing arrangement for learning disability service in Cambridgeshire

Fears have been raised that adults with learning disabilities in Cambridgeshire could face a “poorer quality” support service due to a “breathtaking” failure to agree cost-sharing arrangements.

The county council has agreed to terminate a shared funding arrangement with the Integrated Care Board (ICB) for the service that helps adults with learning disabilities and their families.

The authority wants to continue to work in partnership on the service, but the ICB has announced it wants to pull out fully.

Cllr Richard Howitt (Lab, Petersfield), chair of the county council’s adults and health committee, found the disagreement “astonishing” and feared it would cause a “poorer quality” service.

He told the committee: “I find it breathtaking that you have senior people, skilled, mature people from both sides who spent, to my knowledge, a year and a half sitting in rooms together and have been unable to first agree a fair cost sharing arrangement and then even to be able to agree a mediator or adjudicator to do it.

“I just find that astonishing and deeply sad that that has not been able to happen. It certainly is not within the spirit of partnership working.

“What is also deeply sad is in the letter we got, it said ‘Well we are going to withdraw from integrated management of the service’.

“We said we will withdraw from the joint cost sharing arrangement, which essentially would mean more work by finance people on both sides, but we wanted to carry on providing an integrated service, which is better for the service users. That is what we said and they have said no they will not agree to that.

“We hope they can be persuaded to change their mind on it.

“I do believe if they do withdraw from the integrated service there will be a poorer quality of service and that is why I think the next phase of this is us advocating very strongly with our health partners that they should not go through with that threat.”

The Cambridgeshire Learning Disability Partnership has been running since 2002 and provides integrated health and social care services to adults over 18 with a learning disability and their families.

The council and the Cambridgeshire and Peterborough Clinical Commissioning Group, now the ICB, had an agreement in place to run the service, including a pooled health and social budget.

A report to the council meeting said the £122million budget for the shared service was split, with £93.7m provided by the council and £28.3m provided by the ICB.

Following an independent review, the council sought a new negotiated settlement with the ICB. But officers told a council meeting last week this looked unlikely and the funding arrangement is proposed to be terminated from August next year.

The report said: “The agreement does not appear to be operating in the way it was originally intended.

“Significantly, the governance arrangements specified in the agreement are not being fulfilled which presents a significant governance risk to the council and does not accord with the way in which the agreement is intended to operate.

“This means that the council is unable to mitigate financial risk and no appropriate mechanism exists for resolving issues such as the financial contributions which has left the council at a disadvantage, which is unsustainable.

“There has been no progress in revising the risk share arrangement in a timely manner. This means the council is carrying significant financial risk and cannot invest its resources fully to support people with social care requirements.”