So the media diatribe has hit fever pitch in recent months around Health and Social care and its impending crisis. A crisis that seems to have been the rhetoric for almost a decade now but are we any closer to a solution. Sadly, I very much doubt that we are but this isn’t for the want of trying.
Many private care businesses continue to thrive and offer outstanding forms of care against all odds. Why? Because they CARE, they are looking to be dynamic and ensure services are available to those who need them, but they are in different forms innovative and structured. The downside of this is that its only more and more so becoming available to those that can afford it creating another equality divide in our society between those that can and those that cant afford Care.
Although this is not the only problem or divide – there is a clear theory that the solution lies within joined up services for Health and Social Care and the realisation that the 2 areas or services, however you want to frame it are actually extensions of each other. Social Care provision can be reactive and reduce hospital admissions by being the first port of call over 999 emergency services. Community hubs can support people of all ages with difficulties without NHS intervention by spreading the burden of care effectively. So why is this idealism such a distant utopia rather than a current working practice.
If you’ve ever sat through an assessment for NHS Continuing Healthcare funding on behalf of a relative or service user, you may well have found yourself arguing with assessors about the difference between a healthcare need and a social care need. No doubt you’ve also been told that your relatives needs are just social care needs, and that they aren’t ‘eligible’ for any funding. Here lies the route course of the problems the nation faces when looking at care.
There is a deep routed cavern of divide between Health and Social Care they are seen as almost war torn enemies seeking to protect each others funding streams and budget Spreadsheet. The effective outcomes of the end user do not even come into focus until something goes wrong, and when I say wrong I mean very wrong and then the next step is the blame culture to find a suitable finger to point. Rather than learning from the mistake and making a change.
But what exactly is the difference between a healthcare need and a social care need?
Errors in defining care needs – and defining them as either healthcare or social care are the cause of most Healthcare disputes. People in full time care who clearly require at least some degree of nursing care – and even those who require 24-hour nursing care and who therefore have significant nursing needs – seem to be routinely told their needs are merely social care needs.
The reason for this? It means the NHS can relinquish responsibility for providing (and funding) care. The person will instead be means tested and told to pay for their care. And yet, in the UK, healthcare and nursing care are free! I hear you say. Families understandably find it exasperating and end up being forced into exhausting processes. What’s worse, the process is conducted and overseen by the very NHS people who have denied the funding in the first place – and who hold the purse strings.
The anecdotal scenario above is commonplace and brings up some core themes and questions which form the basis of the problems and what needs to be irradiated for any chance of getting to our utopia.
Essentially the definition of Health and Social Care needs to be made clear and public. Yes the NHS is FREE but on-going long term care is NOT and the sooner we realise this the better we will all be at accepting the probability that in our lifetimes we will all have to fund part of a care package for ourselves or a loved one.
Next step is that Health and Social Care need to openly work together to define clear entrance and exit points in care meaning that we all have clear and public guidelines of where on the care road map we sit. Then the transitions from emergency services into support services can become more fluid solving many of the problems, which have been publicly cited in recent years. This will give choice and independence for the sector to service appropriately and those in need to get the right care at the right time. Ultimately adding the right value where it is really needed
Adam Hutchison BSc MA – Managing Director of Belmont Sandbanks Care Group & Vice Chair of the Kent Integrated Care Alliance.