Integrated Care in Salford
A UNISON Report Compiled by
Salford City UNISON and Salford
Health UNISON
Background
• In late 2014, Salford City Council informed its
recognised trade unions that discussions were
underway to create an “Integrated Care Organisation”.
• The intention was to transfer the City Council’s adult
social care services into Salford Royal NHS Foundation
Trust and to integrate them with SRFT’s Community
Health services.
• Rationale of integrated health and social care:
– less duplication – cost savings and joined-up care
– greater investment into preventative services, largely
based in the community.
A Simplified Model of Salford’s Adult Health &
Social Care System (1): Pre-ICO
COMMISSIONER
Salford Clinical
Commissioning
Group (CCG)
PROVIDER
GM West
Mental Health
Salford Royal FT
Acute
Community
Salford City
Council
Social work
Private / CVS
Social care
A Simplified Model of Salford’s Adult Health &
Social Care System (2): With ICO
COMMISSIONER
PROVIDER
GM West
Salford Clinical
Commissioning
Group (CCG)
Mental Health
Salford Royal FT
Integrated Care
Organisation (ICO)
Salford City
Council
Acute
Community
– a division of SRFT
Social work
Private / CVS
Social care
Accountability of the ICO?
• Council remains initial commissioner of social
care services.
• Councillors sit on ICO board.
• However, does even this give leaders of
unelected NHS Trust too much power, given 5
year + 5 year contract?
• How do we protect services and advocate for
ethical commissioning?
Process
• City Council staff were engaged in a robust
consultation exercise, BUT decision had
already been taken that SRFT would host.
• SRFT staff hardly consulted at all.
• Staff groups kept separate for a long time.
Employment Issues: TUPE?
• Public to public transfer?
• They say YES, we say NO.
• Solution – Get everything in collective
agreement 
Employment Issues:
Non-TUPE Ts and Cs
• Pensions  - SRFT applied for and got LGPS
Admitted Body Status
• Cost of living awards  - SRFT agreed to apply
NJC Pay Awards
• Continuous service  - Redundancy
Modification Order an Obstacle. Does GM
Devo have the answer?
• New starters??? – NJC? Local or National?
A4C?
Post- Transfer Issues
ICO set up on 1st July 2016
Different terms & conditions for staff doing the
same job
Examples of the employment complexities of
integrating services:
(1) Continuity of service
(2) Job evaluation
(1) Continuity of Service
For formerly Council-employed staff
• Continuity of service protected if change
employer within the NHS
• But other social work staff are employed by
Councils – more likely that they would move
to a LG employer
• Not clear if continuity of service applies if
move from Health back to LG
(2) Job Evaluation
Job Evaluation Profiling
• LG jobs to be converted into Agenda for Change
pay scales
• Social work jobs are difficult to match to national
AfC job profiles
• LG job descriptions require much less in regard to
essential education
• AfC scores jobs on 16 factors
• Points awarded determine the banding of the job
AfC Job Evaluation: Scoring Chart
AfC Job Evaluation: Band ranges
Job Evaluation Concerns post-transfer
• Where other areas pursue integrated care
models - danger of same job being banded
differently
• From national profiles to local profiles?
• Better if social work job descriptions were
profiled at a national level into the AfC
Profiling System