Interview with Neil Pringle, Chief Executive Herefordshire Council
What started out as a threat to the long-standing partnership in Herefordshire 12 months ago has turned into an opportunity and has brought public services closer together in the county.
Government plans to reconfigure health services in the area were seen as a huge danger to the Herefordshire partnership, which had existed since the late 1990's. Neil Pringle explains:
“We've always been lucky. We've had the same boundaries for all the major players, health services and the command unit for police. This has been important for us. There has always been a willingness to work together.”
Under the proposals the PCT would lose its coterminosity with its partners and was likely to border more than one area.
Pringle says the partners fought a hard case and went through a 'fit for purpose' test with the strategic health authority (SHA) to prove the benefits of maintaining the PCT's boundaries. It is Herefordshire's particular geographical challenges that have made partnership working and joint boundaries so important in the county. The partners cover a huge sparsely populated area adding to the expense of providing services. He says:
“This is a challenge of resources and we had to explain the impact of our geography.”
The campaign was a success and it was out of this that the options for much closer working and for shared services emerged. Pringle says:
“What started out as a threat turned into an opportunity.”
Over the past 12 months the PCT and the council have been working together on a new more integrated partnership strategy. Part of this will be joint commissioning and delivery teams. He adds that managing financial risk will not be an issue yet for the partnership as it is not planning to move vast sums of funding around.
“We are trying to create headroom in budgets to spend more on the front end and less on administration. Once we have demonstrated a track record on economies we might get greater freedom over budgets in time.”
Managing the challenges
Pringle says it is still early days and one of the challenges will be reassuring the county's other partners and keeping them on board.
“There are two big partners already joining to make an even bigger partnership. We have got to be careful that it doesn't become a threat to our other partners. We have to make sure it won't be all one-way traffic from us, we'll have to manage that.”
Governance and cultural differences are still hurdles to overcome for the partnership.
“Getting the governance model right without amending legislation is one of the hardest issues. We have six non-executive directors, 58 elected members and eight cabinet members. We are yet to solve it.”
He says culturally it is often easier to focus on what health and local government do have in common. But he concedes that it's easier for councils to plan long-term, while finance and policy shifts more quickly for health.
Regardless of these challenges Pringle says the high level outcomes on the health of the county's residents, including smoking cessation, has made the partnership essential for the county.
17 October 2007