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Making plans….

14 January 2019

Difficult to piece together a headline today, in light of the political ramifications of the coming days.  Whatever we discuss now, it is hard to focus on anything but Brexit, and whilst the political enthusiasts pour over which amendments the speaker includes in tomorrow’s vote, and deliberate over the voting numbers needed, the core issues of social care, health and housing remain firmly on the back burner.

Well, that is not entirely the case, as of course last week saw the arrival of the NHS Long Term Plan. I think it is symptomatic of the way in which Brexit has sucked up the majority of domestic politics that the expectations on the NHS Long Term Plan were so high.

Having reviewed a lot of the commentary surrounding the plan, I can empathise with the views of many, who were ultimately looking for the NHS plan to be much more of a reflection on what needs to be changed across the system, not just within the NHS.

Comments decrying the lack of focus on housing and care abounded, leading some to surmise the NHS was guilty of believing the media narrative, and feeling it really could save the health of the UK population single handed. However, it was, of course, always intended to be a shopping list that outlined what was needed, and how it would be delivered to meet the priorities set out for the funding announced last summer.

That said, there were a number of references to care that are to be embraced and built upon.

The first of these talked about the expansion of the learning from the Vanguard work on Enhanced Care in Care Homes. Of course this was contexted in the impact on acute services, but the opportunities for better integrated care within care homes is only to be welcomed.

There was, unsurprisingly, a very prominent focus on how technology will transform health, and as a consumer of healthcare now and going forward, it is hugely encouraging to see this take prominence. One way in which this connects to care was the announcement that all care homes will have access to NHSmail, a key element of the digital architecture that will enable the rapid exchange of data about people across the health and care system.

The positive narrative around the community focus and the widespread engagement with person centred approaches provide optimism for a more shared language of the future; who knows, the next 10 year plan might have moved on from patients to talking about people…..

However, whether or not it was intended to just focus on the NHS, the implications of the plan are far reaching for a wide range of partners – care and housing to name but a few. When the plan is read from the perspective of those adjacent to the plan, there are causes for both optimism and concern. Many of these appear in the context of workforce, and as this is an area where there are options for perhaps the most influence, then it is worth setting out social care’s stall.

Workforce development will be funded through a settlement for Health Education England in the forthcoming spending review. Therefore what is in the plan now will be subject to further scrutiny in the form of a workforce implementation plan to be published later in the year. This means that we need to act now to ensure the opportunities are maximised, and the risks mitigated.

The report talks about the need to create a secure and capable digitally literate workforce. This is an absolutely key opportunity for working together. All of the digital elements of the plan are just as relevant for care staff, and therefore the opportunities to connect are huge. As mentioned, the access to NHSmail is key, and for this to happen; there is a detailed backstory for care providers around compliance with the Data Security and Protection Toolkit, alongside cyber security requirements, all of which will be digital and Information Governance skills that could be learned side by side with health colleagues.

I strongly hope the workforce implementation plan will actively look for these opportunities to engage.

However, there are other more concerning messages about how the NHS wishes to incentivise retention which will impact on social care. The statement that every nurse graduate will offer a five-year NHS job guarantee within the region they qualify is really concerning, as well as the guaranteed placements for online nursing degrees.

We know from Skills for Care NMDS figures, numbers of nurses entering social care has fallen dramatically in recent years, and we absolutely need to be showcasing the full range of opportunities for nursing staff across the wider health and social care sector.

Aside from these concerns, there is much in the plan where there feels like real opportunities for some excellent joint working and system wide change. The strong focus on working with partners including the voluntary and community sector is in there.

What we need now is a green paper that will help us understand how social care of the future can get planning so we are ready to take forward the myriad of opportunities for joint working that the plan presents. 

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