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A brave and bold new world: my vision for social care

8 January 2018

The green paper should put care at the heart of communities and invest in the people and innovations that will deliver it

Ambitious, brave and audacious: that is what I hope the green paper for social care will be. It must be focused on the future; clear on how care must transform to face the challenges ahead. Alongside that vision, there should be a mechanism to fund such an ambitious and life-changing world. But for the time being, let’s focus on what that world should look like. The reform agenda must focus on four key areas.

Q&A - What is the social care green paper?
The much-anticipated green paper on social care for older people is set to be published by the summer of 2018 – although, having been promised before last year’s general election, the sector had been hoping the paper would appear much sooner. 

It was also hoped that the green paper would address needs across the entire adult social care sector. Instead, the paper will be limited to the government’s plans for improving care and support for older people and tackling the challenges presented by an ageing population. 

There will be a ‘parallel work stream on working age disabled adults’, but some are concerned this report will focus on getting more disabled people into work. 

The government has invited a number of people to advise on the paper, including Paul Burstow, chair of the Social Care Institute for Excellence; Sir Andrew Dilnot, the former chair of the Commission on the Funding of Care and Support; and Caroline Abrahams, charity director of Age UK. However, no user or care worker representatives have been invited to take part in consultations. 

The proposals set out in the paper will build on the additional £2bn the government has provided to meet social care needs, reduce pressures on NHS services and stabilise the social care provider market over the next three years. Once published, the paper will be subject to a full public consultation. 

Across the country, we are woefully unprepared for the demographic changes ahead. But the green paper must also acknowledge changing communities, the increasing complexity of need and expand care to address the needs of hard to reach groups, such as the LGBT community, people with learning disabilities, people with dementia and black and minority ethnic groups. The paper needs to focus on creating a social care system people can engage with and that they feel represents a positive choice for all citizens to support them to live safe and fulfilling lives.

Whether residential or home-based, we need to look at some of the models of delivery emerging across the sector, including the establishment of Buurtzorg-inspired wellbeing teams that are developing to meet needs within homecare. We need to understand how the built environment is adapting to encourage more household and village-based approaches to residential delivery, and the potential for new models such as Dutch-inspired care hotels. In addition, intergenerational projects here and abroad need to inform the way we think about the critical connections between young and old. Finally, we need to be open to where the integration between health and care leads us in terms of future models. The not-for-profit care sector can provide a strong showcase for innovation in all areas.

We know that staff recruitment and retention is one of the most pressing challenges for any care provider, and that this pressure builds in cost, risk and – most importantly – interruptions in the continuity of care that everyone would benefit from addressing.

The green paper must bite the bullet around professionalising the sector. It should ensure that all staff are rewarded fairly through localised commissioning arrangements and deliver positive messages about the centrality of social care to a fair and equitable society. In essence, we need pictures of Jeremy Hunt with his sleeves rolled up visiting care homes on a regular basis.

The green paper must take up the challenge of how social care can embrace the opportunities offered by technology. This particular revolution cannot come soon enough.

The efficiencies and productivity gains to be achieved through strategic investment in technology should be factored into the future of care. The pendulum needs to shift, whether the focus is on the frontline through electronic care planning and medication management, or on behind-the-scenes changes to measuring staff competence, rostering or risk management.

Social care must be able to harvest the rich data locked away in paper-based systems. We need to use it to demonstrate impact and drive service transformation. We should dispel the fears of what greater automation might deliver within care. This will remain a people industry – staffed by people, for people – but we must not shy away from the potential our new friends Pepper and Paro can bring.

It is only when we are clear about what the future looks like that we can put in place a system that will fund and sustain that future. A future that puts social care at the centre of communities, rather than providing yet another sticking plaster to tide us over, creaking towards another crisis.

Vic Rayner is executive director of the National Care Forum

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