Outcomes and Prospects

17 In general the first LIFT developments to be completed were those less challenging ones that could be achieved quickly. Later projects are more likely to address LIFT's long term aims, such as involving Local Authority services to be able to offer patients integrated health and social care. Despite problems in getting started, local outcomes are encouraging and future prospects for LIFT look good, providing performance measurement and accountability frameworks are strengthened.

18 Local areas, guided by Partnerships for Health and the Department, should strengthen their monitoring and evaluation frameworks. The Department in turn would benefit as this would improve its understanding of how LIFT is contributing to the modernisation of the primary care estate and integration of healthcare provision in the areas of greatest need would improve.

19 The accountability arrangements also need to be strengthened. The accountability of the LIFTCo to the Strategic Partnering Board is well defined. At present, however, there is no one organisation to oversee the performance of the Strategic Partnering Board, a body established locally in each LIFT area to commission services. Overall oversight of the Strategic Partnering Board and promulgation of guidelines to help minimise tensions which may arise where public sector employees are fulfilling several roles in the LIFT structure would reinforce the accountability arrangements. Additionally as the Strategic Partnering Board represents multiple clients, it needs to be clear to the LIFTCo at the outset of a project who the customer is. For example, where a single Primary Care Trust is driving a project, the LIFTCo may deal directly with them as the client on a day to day basis. But where joined-up delivery from multiple clients is required, the Strategic Partnering Board will need to ensure an effective negotiations framework is adopted.

20 As a result of their experience to date Partnerships for Health have announced some changes for the planned fourth wave of nine LIFT schemes. The most notable change is an extension of the timetable to 15 months to reflect the fact that the 12 month timetable has proved too ambitious and trying to meet it can be counterproductive.