Of course the short answer is that social care has been perceived for too many years to be part of the problem when in fact is it most assuredly part of the solution. The health and care sectors are only just now beginning to realise what a pivotal role social care can take in supporting those in need of care. The more this realisation takes hold the more successful the integration of health and social care will be and more importantly, the better the experience will be for those in the care and health pathway. This could not be a better time to solve the problem in a collaborative way now that the Secretary of State for Health has included Social Care in his portfolio, so let us make the most of the incentive.
Whilst people work behind the scenes on the forthcoming Green Paper and Lord Darzi and his team of largely non-social care experts wrestle with the consequences of 10 years of severe austerity, which led to a massive reduction in the number of people receiving social care, this is the time for localism to become the predominant factor in shaping the much needed cohesion between social care and health care. So while the Green paper is hopefully dealing with things like care caps, strategic funding and so on, Lord Darzi is dealing with examining the quality, safety, effectiveness, timeliness, efficiency and equitability of care in the NHS and Social Care and how to establish the funding reforms needed to drive improvements in the quality of care. Locally, the Care Associations established around the country will need to rise to the challenge even more to ensure that cohesive systems emerge that can deal effectively with the relationships between social care and health care. This continues to need a new level of transparency and trust between the Care Associations (who can effectively represent care providers) and local organisations such as the Local Authorities, CCGs, regional ADASS, the LGA, Pharmacists, GP Surgeries, NHS Hospital Trusts and regional CQC contacts.
A lot has been achieved so far. For instance, the Lincolnshire Care Association led the way with developing the Trusted Assessor programme requiring an initial leap of faith between the NHS/CCG and care providers. The same programme is now developing through the Bedfordshire Care Association with approved funding from the Better Care Fund. Another interesting example is the Vice Chair of the Surrey Care Association who has the job of promoting new ideas for market development in the county such as managing care to cut hospital admissions and finding ways to get people out of hospital sooner but without the risk of re-admission, finding ways for cohesive funding of care so the money goes with the individual, to name just a few of the themes he is working on. My own thought about this is that if all the local developments such as these could work towards combining budgets between health and social care then the right systems will naturally develop out this common ownership and the individuals themselves will see the benefit. It is pleasing to note that a common link with these developments has been the Care Association Alliance which provides the link between all the local Care Associations across England.
Localism has also found its way into the development of the Vanguard programme; in fact, it’s an essential ingredient of it – 15 new models care have developed across the country ranging from ways to encourage and support self care at home, to hundreds of pharmacists, funded through NHS England, helping to reduce over medication and unnecessary hospital visits and the South Somerset Symphony Programme which is developing a new cohesive system across all organisations to deliver joined up care. The Somerset Care Providers Association played a substantial part in the early development of this particular project.
On the other hand, the NHS Sustainability and Transformation Partnership project seems to have fallen shy of engaging in the local context and tended to exclude anyone other than the NHS and Local Authorities. This left social care out of the equation for the STP development programme. Thankfully, this has been recognised and the Care Provider Alliance (who represent all the national Care Associations) is charged with rectifying this omission. To quote their opening consideration of this task they say that ‘if we want to transform the system, the whole system needs to be engaged, not just one half of it’.
The tide is encouragingly flowing in the right direction at last. Provided that the strategic work manages to produce a financially sustainable health and social care partnership, then the local initiative, whether formally through the Vanguards or through less structured engagements, can flourish.
I think this answers the question!