Health care planning teams and joint care planning teams: incompatible or complementary?

One of the anomalies after the 1974 reorganisation of the National Health Service was the creation of joint care planning teams at area level and health care planning teams at district level, with no formal mechanism for direct communication between the two. The first mention of joint care planning teams was in a Department of Health and Social Security circular published in 1976.1 These teams were necessary to ensure joint planning between corresponding health authority and local authority. Their function was "to advise the NHS and local authorities on the development of strategic plans and guidelines covering priority services. . requiring a joint approach to planning."2 Their members were to be drawn from both authorities. The reason for creating areas in the 1974 reorganisa-tion was to facilitate collaboration between health and local authorities, and so area was the appropriate level for such joint planning teams to be set up. The pattern in most areas was for the joint care planning team to be set up and for that team in turn to set up joint care planning team subgroups to consider particular groups such as the elderly and the handicapped. The subgroups reported to the joint care planning team, which reported to the joint consultative committee, which in turn advised the area health authority and local authority as appropriate. At a slightly earlier stage, working to a DHSS circular published in 1973,3 the district management team in most health districts set up health care planning teams to consider particular client groups or services. These teams reported to the district management team, which then drew up its plans and advised the area health authority accordingly. Their function was "to develop operational plans within the general framework of area health authority strategic and operational guidelines and to influence future strategies through commentary on these guidelines."2 Their membership was to be broadly representative and to include local authority officers. How the two sets of teams were to avoid duplication of effort or coming up with conflicting advice was never made clear. Arrangements were particularly confused because in most cases health care planning teams had been set up from 1974 onwards, whereas the first mention of joint care planning teams and their subgroups came in 1976. District based planning was therefore well established before area based joint care planning teams were considered. The potential for confusion and acrimony was enormous, and unfortunately this potential …