Engage: New Government must introduce long-term funding settlement for social care
The New Year has brought a new Government and it is our earnest hope that it will bring some long-term policy on how we fund and deliver social care. For too long social care has been the Cinderella service and if we are not careful this will continue with the new Government having made some significant commitments about how they will fund the NHS but as yet, little clarity about how social care will be both funded and developed in the future.
What is clear is that the NHS and social care are two interdependent bits of the system and one cannot thrive without the other. Whatever money the Government allocates to the NHS this will not be enough unless social care is able to support people with long-term conditions. The gap between NHS and social care funding has been widening year on year and successive governments have failed to realise that the challenge of the 21st-century is how to support people with long-term conditions and enable them to live well. The NHS funding will soon be hitting in excess of £200 billion a year and yet social care is allocated a derisory £18 billion.
This funding allocation stems from the 1948 formula where the majority of people were diagnosed with the condition went to hospital and came out either cured or dead. The reality of the 21st-century is that many people are living with long-term conditions and they need support in order to live well and be as independent as possible. This is the reality of the system, but it is not the reality of how funding has been allocated and we need to change that.
As we start a new decade, we do not need more discussion, analysis or Inquiries into social care, what we need from our new Government is a clear vision plan of action and a funding settlement which takes account of the ever-increasing need.
This new decade can also be a moment when it is not only funding that we start to review. Frankly there are not enough people to staff services in the way we currently deliver them. If we are going to meet the challenge of the 21st-century we will have to start doing things differently and technology will play a big part in this new system.
Our challenge with deploying technology is to ensure that it improves the quality-of-life of the service user and gives them far more choice autonomy and control. I believe that if we use technology with this objective, we will see our system transformed and many more people living more independent lives. One thing I’ve been really sad about is the way in which technology has been used in the past to police the workforce, rather than to deliver better services to the people who use social care.
I have been astounded at the way in which some local authorities will allocate money to set up systems that monitor when a domiciliary care worker arrived in somebody’s home and what time they left and this is done as a means of monitoring the contract, rather than identifying the needs of the service user and whether or not their outcomes are being met.
In this brave new world where we hopefully will see a new approach to social care, let us start by reminding ourselves that the purpose of social care services is to enable people to live well and this must be our focus in the future.
I have seen so many countless examples where technology is being used to improve care and have spoken to service users about how they experience technology and their responses have been extremely positive.
There are now systems that will enable care providers to know when somebody has got out of bed in the night and whether or not they return to their bed in a reasonable time – There are opportunities for people to speak directly to service users without having the intrusion of going into their room and there are some fantastic examples of how technology can be used proactively to ensure people’s health is maintained.
I recently saw a fantastic system where residents of a care home were wearing a “Fitbit” this device was transferring data to the care home staff and to primary care and was enabling a much more proactive approach to support and to medicine. One man who was living with advanced dementia and who had a history of urinary tract infections had his life transformed by a Fitbit that transferred data about his temperature to his doctor. The doctor saw that a slight rise in temperature was the prayer used to a UTI and was able to put in proactive medicine which enabled the person to live well and not to attend hospital. This technology was cheap and accessible but it was transformational and the person who had had so many visits to hospital never had to visit an A&E unit again for the rest of his life. As his daughter said to me, this is great for my father and fantastic for the system.
I hope that the start of this new decade will be a new dawn for social care and will finally be the moment when governments and wider society start to recognise the impact social care services have on people’s lives and start to support our sector to be able to deliver high quality care that will sustain people in their communities and give them a good life.
The Prime Minister talked in his victory statement about the people who had “loaned” him their vote and one area where he can really make a difference is by delivering a long-term strategy on social care. In many of the constituencies that “loaned” the PM their vote, social care is one of the biggest employers and it is central to local economies, as well as to the quality-of-life for local people.
I hope that 2020 will mark a new dawn for social care when it is regarded and respected in the same way that the NHS is and we can finally take our place as part of national infrastructure.
Professor Martin Green OBE is Chief Executive of Care England.