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
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
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!