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Better Together!

7 August 2017

Vic Rayner
Executive Director
National Care Forum

This has been a week where the wider news agenda has been dominated by Brexit and the potential impact of a more disconnected UK on areas of our economy. However, I am pleased to see that social care has been bucking the trend – and keeping a strong focus on the issue of togetherness – in varying degrees of positivity!



Whilst I am not sure that this word was in common parlance prior to the airing of the inspirational documentary ‘Old People’s Homes for 4 year olds’ last week, it most certainly was the word on every ones’ lips both during and after the two shows. Firstly – if you haven’t seen the programmes – then please do go and see for yourself the wonderful learning that emerged from a six-week study of the impact of bringing together residents of St Monica Trust with four year olds from a local Bristol nursery. The programmes can be viewed here

This programme has really ignited a valuable discussion about intergenerational approaches to service delivery and development – and whilst much of the noise has focused on the impact on the older people – I think that there will be strong evidence of the positive impact on the young people as well. Whilst the idea for the UK experiment was cited as the result of a series of American experiments, it is also an idea that has taken hold within Japan. The practice, known as Yoro Shisetsu, facilities for the elderly and young, is well developed, with a very strong sense of shared ‘assets’ of young and old, and mutual volunteering as part of the model. More details of it can be found here and I was interested to read the connection to the animated film Ponyo, that fans of the great director Miyazaki might have watched (in my case about 20 times!)

There has been a great response to the programme from older peoples’ practitioners including the British Geriatric Society, bringing reflections from Dr Zoe Wyrko (or @geri_baby ) about the importance of the film and its future impact on understanding how to support older people. 


It has also been important in the aftermath of the programme for St Monica Trust to be really clear about what it is going to do next – both to sustain the existing relationships formed through the ‘experiment’, but also to demonstrate how they plan to embed the learning from the work into their mainstream approach. They have been quick to share this, and their legacy to the programme can be viewed here

One of the critical messages of the programme was, I felt, the focus on mental health. Whilst all the changes to people’s physical health were absolutely critical the positive impact on mental health was one of the most stunning changes. This has led to a let of discussion around the values of intergenerational connections on friendship and tackling isolation. Very important resources have come to the fore to help organisations to address this and these will be particularly useful for organisations who are thinking that they do not have the resources or space to build shared provision on existing sites. A few key links can be found here and here, and there are many more out there.

One of the other stories that really struck me from the programme was how it supported people who are ageing without family members. A recent briefing paper from Kirsty Woodard, Ageing without Children. The point is made that people ageing without children are 25% more likely to go into residential care and the issue of 'invisibility' of people ageing without children is picked up in Our Voices.

Finally – on this key issue – it is important to remember that Intergenerationality does not just extend to older people and 4 year olds – there is a lot in between! For example, this recent example of Finnish students renting homes in a Helsinki care home and befriending older people in a state-run care home and helping provide a range of social activities.

In the light of the popularism of intergenerational activity – I predict a remake of May to December in the not too distant future…….


Integration of Health and Social Care

Having heard a lot about how seemingly straightforward it is to bring together the old and the young – often characterised as two extremes of society – with more that divides them than unites them including culture, attitudes, language and experience – you would think that bringing together two sectors with shared vision, goals and more often than not shared users of services – would be a walk in the park!

However, it would seem that all is not well in the integration camp. With a pointed commentary around the way in which the additional funding for social care is geared towards supporting NHS discharge, David Oliver, the previous chair of the British Geriatric Society outlines the challenges that this bring. In addition, we hear more about the strained relationships between Local authorities and NHS partners. We already know that the LGA has withdrawn its support for the Better Care Fund planning guidance, citing the singular focus on hospital discharge to the exclusion of other local authority responsibilities. It seems that there is growing discontent in some areas as to how the integration agenda is developing, and how true a partnership it represents.

However, the ‘Better Together’ mantra does continue to emerge, and the continued assertion of the importance of health and care working together to address individuals’ needs is reflected in a number of key articles this week. Firstly, the Guardian picks up on the potential for the recently announced Accountable Care Systems seen as the answer to the ‘fractured health and care system’. The article highlights how this is beginning to happen in some areas. In addition, we know that in Manchester, they have had more time to address these issues, and it is now that we are beginning to see case studies and examples coming forward which demonstrate the potential for some innovative thinking and challenges to current systems emerging from the presence of devolved budgets and thinking. One exciting new approach is that advocated by Evermore, and this can be read about here

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