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United in our Discontent

11 March 2019

Well at least we are all agreed on one thing…… no one is happy with what we have got.  

Organisations and representatives from across the country are making it abundantly clear to government the intense pressure the social care sector is under, and the knock on impact of delaying the green paper and therefore not moving any closer to resolving the funding and future focus of social care.

Providers and their hardworking teams across the country despair at the lack of forward focus on the very services that they are straining every sinew to ensure good quality provision is kept on line, meeting the standards of safe, effective, caring, responsive and well led. Despite their efforts, as Mike Short’s eloquent report ‘Say Hello, Wave Goodbye’ reflects, the level of closures of homes across the country has resulted in a net loss of over 3000 beds.

This is, of course, against a backdrop of significant demographic shift impacting the country, with every commentator predicting growing demand for both residential and homecare services. Whilst at the same time, Age UK annual statistics make it clear the shortfall in provision is not just a problem for the future. Its most recent report suggests at least 1.4 million older people who need basic support with bathing and getting in and out of bed, the most fundamental activities of daily living, are not receiving the help they need. 

The Care Quality Commission is convinced there is a high level of discontent in the care people are receiving, feeling that a very significant silent majority, almost 7 million, who have used health or social care services in the last five years, have had concerns about their care but never raised them. Of these, over half (58%) expressed regret about not doing so. Therefore, the CQC are leading a drive to get citizens to 'Declare their Care'

Meanwhile, the Kings Fund has been reflecting on the British Attitudes Survey; its report on Public satisfaction with the NHS and social care system 2018, which showed levels of satisfaction falling across both health and social care, is not a great advert for integration. The core reflection on social care alone stated, “Satisfaction with social care services was 26 per cent.”

ADASS has heralded a sustained long-term campaign around the need for a sustainable funding settlement. Meanwhile, Town Hall Chief Executives are busy raising the alarm over a £1bn shortfall, even after they have maxed out any social care precept options.

In an unusual and welcome step, colleagues from across the health sector have come together to form the Health for Care Coalition.  Niall Dickson, CEO of the NHS Confederation and spokesperson for the coalition argued: “Everyone’s mind is elsewhere just now, but this is a national scandal and a national disgrace. Record numbers of older people are being left to struggle each day without the care and support they need. It leads to a grossly inefficient system - the cost of doing nothing is great and the personal impact on individuals and their families can be devastating.”

Jeremy Hunt, whilst still Secretary of State for the Department of Health and Social Care, talked over a year ago about the weight of ‘stalled reform’ of social care that sat on his shoulders, as he advocated his seven principles against which future reform should be judged. You can see my take on his speech almost a year ago today here.

We know there is no silver bullet, quick fix, no panacea, pot of gold, money tree, unicorns carrying horns a plenty and every other analogy designed to manage expectations.

But, with all credit to the quick wit of Simon Bottery, when you have waited longer than it takes for the gestation of a baby elephant (a mere 95 weeks in comparison to the 105 weeks and counting since the announcement of the social care green paper), you are quite keen to get the thing out on the table – apologies in advance for those whose imagination runs amok with my mixed metaphors.

The green paper is, after all, only the starting point – don’t make the people who so desperately need reform of a service they are not satisfied with, the million plus who are currently not receiving the care that they need, those who can see no other way than to shut up shop and stop providing care, or Directors of Adult Social Services, Town hall chiefs and health colleagues who are ringing every alarm bell they can lay their fingers on – don’t make them wait any longer.

Much as it has ever been – publish and be damned! 

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