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Social care

Published: 14 March 2017
Sector: Healthcare

Thanks a billion but “please sir can we have some more?”

The crisis in social care in England has forced Chancellor Philip Hammond to pledge an extra £2 billion over three years to help ease the pressure.

The money, with £1 billion promised in 2017/18, follows intense pressure from MPs and councils, but falls short of the levels of funding we believe are required. The government has been under pressure to offer more resources for social care budgets, with council leaders warning the entire system stands on the "brink of collapse" without an immediate cash injection and a commitment to a long-term solution. Whilst this extra money is welcome, needed and may help to avert a short term collapse, it doesn’t provide a long term solution. So, where is the commitment to that long term solution? Mr Hammond said the government would set out the options for long-term funding of the social care system later in the year - although these would not include a "death tax”.

When tricky problems arose Sir Humphrey used to advise the Minister to announce a Review. We’ve had plenty of reviews into the funding of social care but continuously kicking the issue into the long grass has finally come home to roost (apologies for the mixed metaphors). However long that grass has grown this issue remains more visible now than ever. If we have some clear options presented to us upon which decisions are made, then fine, but please, not an announcement on options which will be “reviewed”.

More funding was announced for Sustainability and Transformation Plans (STPs) and we believe that this is the correct way to go. However, STPs will not succeed unless GP, community health and social care services are increased and improved. Delayed discharges from hospital “bed blocking” to use an awful but recognised term should be alleviated by such an approach and there is also the benefit of preventative work in the community, which will delay or avoid hospital admissions in the first place. Not long ago, all the talk was of such preventative measures but once austerity bit the good intentions went out of the window and we are back to treating the symptoms not the causes.

The NHS and social care are at breaking point and have been failed by short-term party politics. We need politicians from all sides to come together to agree a long-term solution to these challenges. The time to start fixing things is now. Social care funding and a joined up strategy has to be a cost effective part of the solution. We have known about this worldwide demographic trend for many years but previous governments of all colours have declined to deal with it.

There is some scope for local approaches in the provision of care, given the diversity of local needs, but only within a strong national framework that sets ‘floor standards’ and ensures there is adequate help everywhere. This is not true of the system we have today because it is too much of a ‘postcode lottery’ - leaving too many older people with insufficient support or no support at all.

There are a myriad of elements to factor into a long-term solution (too many to cover here) but enabling people to retain their independence at home is what almost every older person says they want. We need a range of graduated help for older people across the country.  At the moment the potentially significant contribution that housing could be making to strengthen the care and support of older people is not really being exploited.  Although the Housing White Paper contains some helpful mentions of the importance of considering older people’s housing needs, the Government’s proposed reforms to the funding for sheltered housing (Local Housing Allowance) run in the wrong direction and should be revised. Surely it makes sense for housing policy to require all new build schemes to adhere to lifetime homes standards or other mechanisms for ensuring that accommodation can be easily adapted as an older person becomes less mobile and possibly develops social care needs.  At the moment this approach is only optional, aimed at specialist housing only and local viability tests are allowing developers to avoid implementation altogether.

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