This week the Health Secretary published the social care white paper ‘Caring for our future: reforming care and support’. Its aim was to set out a vision for a reformed care and support system which would focus on: enabling people to stay independent for longer whilst giving them more control over their own care, provision of better information, the introduction of greater national consistency in access to care coupled with the quality of that care and support services and, improving integration across the health and social care system.
Although full of fine rhetoric and good intent, with a genuine belief and a commitment to the need for urgent reform, I can’t help feeling that once again the government “has failed to produce a clear plan for how care should be funded or a timetable for how these decisions will be considered,” as quoted by Richard Humphries senior fellow at The King’s Fund.
However, on a positive note there is much that can be commended such as the focus on quality and control and access to information, which will empower people to have a much greater say in decisions about how and where they will receive care.
For example, the creation of a portal next year that will provide an explanation of how the care and support system works and who might be eligible for financial support, along with a “comprehensive national, easy-access directory of care providers within the portal” is a good thing. Plus the transfer of resources from NHS budgets to social care, whilst only small, must surely be welcomed by local authorities and clinical commissioning groups as it will give them the autonomy to ensure resources are used to deliver joined-up services.
But on that commitment to provide “high quality, integrated services built around the needs of the individual” this is probably where, from a personal perspective, my greatest concern lies. Having an elderly mother, who has recently been diagnosed with dementia, I have witnessed firsthand the disjointed, inefficient, uncommunicative and often uncaring nature in which the various health and social care services operate.
Lack of sharing of information, lost medical notes, numerous repeat tests, failures to communicate and miss-booked appointments, have all been part of a very stressful experience. But I think the most worrying concern of all is the apparent lack of any one single organisation taking ownership or responsibility for my mother’s care.
There is no doubt our health and social care services face exceptional challenges as our population gets older, and without reform these systems will simply implode. But what gives me faith is that I know that change is achievable and this is what the government reforms are aiming for. But how long will it take? Urgent action is needed now as we cannot afford to pick up the pieces, economically and emotionally, of a broken social care system – from which my own experience can’t help make me think this is the direction we are heading.
I plead for the end of NHS navel-gazing and political debate as the longer we wait the worse the problem will grow. I think what’s key to the reforms and within grasp, is to make care ‘integrated’ and ‘seamless’. This means getting hospital doctors, GPs, nurses, community carers, local councils and charities to work together more effectively and flexibly.
And what is encouraging, is that there is evidence of this already happening. Health and social care services in North Somerset are set to be merged in an effort to create an integrated care organisation, and five NHS trusts, a county council and university have formed a private company to deliver more integrated health and social care inEssex. Plus the Department of Health has recently invested £19m in social enterprises to help fund and assist more doctors, nurses and other public sector workers to run services that are tailored to their local community.
Furthermore, there is innovation and technologies that can make these changes happen. I see on a daily basis what can and is already being achieved through the better processing of data, sharing of information and clever use of medical devices and mobile technology, to quote some examples. And let’s learn from what’s being achieved overseas, like Denmark, Canada and even Mexico.
I realise that the social care white paper is just another part of the jigsaw in a very complex maze, where there is no easy answer. But I like to think that the reforms are creating a groundswell of innovation, particularly in integrated care. We just need to create an environment in which best practice can be shared so we can move forward. It may be too late for my mother but maybe there is hope for me!
