In 1948, The NHS was founded to provide healthcare to all who needed it, free at the point of delivery. In the same year, The National Assistance Act established social care as a separately funded, means tested service. Care and health have remained largely separate ever since.
But we are now 65 years on – the world has changed. People live much longer – a good thing! –but as a consequence many people live with long term health conditions. This creates pressure on both the health and social care systems. People over 65 occupy a significant percentage of hospital beds and require more care and support at home. The boundaries between health and social care have thus become increasingly blurred, with more people having a mixture of needs that are hard to compartmentalize. In the meantime immense pressures on local authority funding lead to increased rationing of publicly funded care, whilst the NHS remains a universal service to all.
It is time we started to think differently; we need to create a new model of integrated health and social care that is more sustainable, better coordinated around the needs of people, and focused on services in people’s homes rather than long term care in residential settings.
There have been endless reviews over the years, the latest of which have led to the Care Bill currently before parliament which will modernise the legal framework for social care and address the funding issue of capped costs. The stated ambition of government is that health and care will be joined up by 2018 but some fundamental questions remain: who should be entitled to health and social care and what should that entitlement be? where should the balance of responsibility between the individual and the state sit? how do we make a service universal yet means tested?
Of course this then leads to wider questions around well being, and how government can best support local services that actually improve people’s well being and prevent them from entering the health and social care system. As new local arrangements are set up through Health and Well Being Boards, with health commissioning transferred over to Clinical Commissioning Groups and Public Health becoming the responsibility of to Local Authorities, does this present us with new opportunities to get this right?
Some call it transformation, others integration … but whatever you call it locally, here at RedQuadrant we are helping organisations to work across health and social care to tackle these problems and find sustainable solutions that both manage the new demand and improve outcomes for people. We have a range of specialists with expertise in health and social care who can help you deliver your vision for integrated care, supporting you and helping you prepare for the forthcoming changes in the Care and Support White Paper.
If you are looking for help to develop your plans, or accelerate existing ones into reality, please contact Frank Curran for an initial conversation – firstname.lastname@example.org or 07515 875381.