Community Care: The First Year: Newcastle: making strides

In the past year those involved in implementing community care in Newcastle have been on a massive learning curve, starting to understand purchasing services, moving towards all kinds of domiciliary services. Provision of services by the independent sector is still developing, leaving the social services department to consolidate its own home care services; voluntary agencies are being contracted to supply others. A new assessment system is evolving. Joint planning is moving forward slowly.

Pinned to the noticeboard in Carolyn Stephenson's office in the social services department at the Civic Centre in Newcastle upon Tyne is a photocopy of a speech made by Dr Brian Mawhinney, minister for health, shortly before the implementation of the NHS and Community Care Act last April. Highlighted in orange are the words: “We must not expect too much too soon. Benefits will flow from these reforms over a decade.... Success will depend not so much on this year's implementation agenda, but more on the continued vision of what can be achieved to allow people to live with independence and dignity.”

Carolyn Stephenson, principal assistant (community care), says she used to read this last year when she was under enormous pressure to get the new system up and running in time for 1 April. “It reminded me that what we were really trying to do was to achieve a very fundamental change for people in Newcastle rather than just meet a lot of management deadlines.”

The new system changed how local authorities delivered social care for people who needed help because of age, disability, mental illness, or chronic illness. Formerly, for those people deemed eligible by a financial means test, the Department of Health had paid the fees for residential and nursing home care direct to those who provided these services. But from April 1993 the …