Social Care - 7 Principles for reform

The Health and Social Secretary Jeremy Hunt earlier this week outlined key principles for the reform of Social Care. These plans included a joint NHS and Social Care workforce strategy and a £1m pilot to ensure that users get a combined heath and social care assessment.

It is his belief that if implemented, these seven key principles of reform will help to deliver a world class social care system.

He highlighted the hard work of staff as “they struggle with the fragmented services coming under unprecedented pressure”. He warned that the NHS was coming under pressure because of delays caused by social care.

To those working in the social care system, this is nothing new, we know that during a time when demand is increasing and austerity measures are cutting budgets something has to give. We know that Social Care is under pressure from all angles.

So what is Jeremy Hunt’s blueprint for the future.

He said “too many people experience care that is not of the quality we would all want for our own Mum or Dad. We need a relentless and unswerving focus on providing the highest standard of care whatever a person’s age or condition”.

“This means a commitment to tackle poor care with minimum standards enforced throughout the system”. He went on to say that this will take time, that it shouldn’t delay the debate with the public about the funding for social care in the future and where it should come from.

The green paper should start what he described as a vital debate.

The key principles of reform are:

1. Quality and safety embedded in service provision

2. Whole person, integrated care with the NHS and Social Care operating as one;

3. The highest possible control given to those receiving support

4. A valued workforce

5. Better practical support for families and careers

6. A sustainable funding model for social care supported by a diverse, vibrant and stable market

7. Greater security for all – for those born or developing a care need early in life and for those entering old age who do not know what their future care needs may be

In his speech he called for “a partnership between the state and individuals and that the green paper will look to bring forward ideas to better “risk-pool” for people with more complex care needs that are disproportionately financially affected.

'Innovation will be central to all of these principles: we will not succeed unless the systems we establish embrace the changes in technology and medicine that are profoundly reshaping our world.

'By reforming the system in line with these principles everyone – whatever their age – can be confident in our care and support system. Confident that they will be in control, confident that they will have quality care and confident that wider society will support them.'

Mr Hunt has also announced:

• A joint 10 year NHS and social care workforce strategy to align the NHS and social care workforces.

• A consultation to extend rights to integrated personal budgets to those with the greatest ongoing social care needs to put more control in the hands of individuals and their families.

• A new £1m pilot in Gloucestershire, Lincolnshire and Nottinghamshire to ensure every user of adult social care will be given a joint health and social care assessment and care plan.

“The way that our current charging system operates is far from fair. This is particularly true for families faced with the randomness and unpredictability of care, and the punitive consequences that come from developing certain conditions over others......

If you develop dementia and require long-term residential care you are likely to have to use a significant chunk of your savings and the equity in your home to pay for that care. But if you require long-term treatment for cancer you won’t find anything like the same cost.” Asked directly if that meant there would be a cap on what any individual had to pay, he replied: “Yes” and went on to acknowledge “the daily pressure” faced by local authorities saying, “We need to recognise that with 1 million more over-75s in 10 years’ time they are going to need more money, and we are going to have to find a way of helping them to source it.”

His remarks disappointed those who had hoped for a tax-funded system that would give social care parity with the NHS. He insisted the element of personal responsibility envisaged in the original National Assistance Act 70 years ago would stay - in reality this means that in future most people will have to pay more towards their care. The Local Government Association, which represents all local authorities, said appropriate funding had to be the “overriding priority” for the green paper and “Government should first make a downpayment on the green paper by injecting additional resources into the system to fund immediate funding pressures which are set to exceed £2bn by 2020”.

The green paper which is due for publish in the summer will hopefully address more of the detail but at present the message is clear, individuals will be expected to fund their care, this will include equity in your home and cash in the bank. I firmly believe that this puts people at greater risk, at the point of care you are dealing with vulnerable people, not just the person entering care, but for those responsible for making decisions on their behalf.

Knowledge really is power at this difficult stage, ensuring that people understand their options, make sure that they are claiming assistance where it is due and making informed decisions.