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For richer for poorer….

10 December 2018

Once again, it appears that what is said, is vastly different from what is done. News appeared over the weekend that the Adult Social Care Green paper has been delayed again – this time until the New Year.

Whilst the weary may well not view this announcement with great surprise, it remains, of course, of dire consequence for those on the receiving end and involved in the delivery of social care.  See the article stating the delay here

Why does it matter when this document appears? After all, we are repeatedly told it will be very ‘green’, which means it is unlikely to focus on firm announcements, and will rather look at broad brush consultative agendas; for many who are desperate for concrete change, this could mean it will feel like we have waited for nothing. There is a risk when you get too close to the deliberations of policy makers and takers the delivery of the paper, the change in the law, the public announcement, the tone of the tweet – becomes the centre of your ambition.

However, it is absolutely clear this paper cannot come soon enough, and the expectations that hang on it should remain exceptionally high – because it is central to people’s lives.

Why do we need the paper?

If we needed any reminder of why we need this paper, and why we need reform – then BBC was able to offer us ‘an up close and personal’ perspective through ‘Care’, which aired last night at 9pm on BBC. If you want to understand the strength of feeling and debate (and like me were banned from watching it in favour of the crowning of King Harry!), then review the twitter feed for this programme.

Ranging from being described as incredibly accurate, to wildly misrepresentative, what was clear, it portrayed the complexity, frustrations, financial strains and on occasion, professional shortfalls of the way in which we deliver integrated health and care. However, once again, it showed we need to look with great urgency at how we deliver care – as it is central to people’s lives.

However, whilst we wait for the publication of the Green Paper ‘to get the amount of attention it deserves’ and for the government reform agenda to begin, there are matters of growing urgency in the communities that we serve.

The issue of growing levels of poverty

In the last month there have been two key reports which focus on the growing levels of poverty in communities across the UK. The report published last week by the Joseph Rowntree Foundation, ‘UK Poverty 2018 comes right on the back of the well-publicised visit by the UN Rapporteur. Both of these confirm the position for many working people, never mind those who are not currently employed – is a life-time away from Theresa May’s much quoted ‘JAM’ community – Just about managing.  

Why is this an issue for care? Well large numbers of those 4 million hard working people that the JRF report identifies, holding down a variety of jobs, juggling caring responsibilities, and coping with significant challenges in life are busy working in our care sector. Plus in the future, many of them, having lived long lives of poverty and hardship, will be entering into our care services.

This leaves me asking a set of key questions about how the care sector responds to these wider issues. For example, are there ways in which we can repurpose the care sector as a locality based community anchor?

The approach has been articulated very effectively in the Preston model, and involves larger institutions such as Universities and Hospitals refocussing their attention on their local community in their consumption, employment, development etc…

Care providers on their own might not have the financial or employment ‘clout’ to make a difference – but together they could create significant change within the communities they serve by buying collectively, employing and training together, stimulating and indeed contributing to a localised supply chain.

How are care providers linked in localities adopting Local Area Coordination, or approaches underpinned by Asset Based Community Development to ensure we learn from these strong movements that recognise our current and potential influence in communities? 

In addition, the Care Workers Charitypresents an opportunity for us as a sector to own these issues. By supporting this charity, that enables workers who experience significant hardship to receive some immediate funding to address a specific challenge, we are putting in place the first strands of a safety net.

But there is so much more we can do that will ensure that workers in care get the support that they need. What are the partnerships you can develop within your community that might ensure that greater support is available as and when needed for workers?

I think that whilst we wait endlessly for the Government to elaborate on the potential for reform of social care, we need to be busy looking at how we can reform ourselves to play a much bigger and more strategic role in the communities we serve. We also need to look at how we can cement the vision of care at the heart of the community, and demonstrate we are in this relationship for the long term - for richer for poorer - in sickness and in health…………

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