I spent the Autumn as co-lead on the theme of ‘Prevention’, which was one of six themes identified by the government in their engagement exercise, seeking ideas from the sector to feed into a White Paper on social care which is due to be published in the Spring. I spoke at lots of events and co-authored a letter with the other co-leads which was reported on the front page of The Times. The letter called for no delays in the timetable for care reform, as had been reported in some sectors of the press. Encouragingly, the government have reaffirmed their commitment to reform and Labour called for cross-party talks.
The presentation the co-leads gave to Andrew Lansley MP and Paul Burstow MP is now publicy available. It outlines a future care and support system which would have moved from a crisis service focused mainly on high end services, to a well-being service which gave people opportunities to plan for their future at a much earlier stage and which focused on people’s gifts, skills and assets as much as their needs. The co-leads saw the Dilnot proposals as an important lever for change of this kind, as they would reduce the fear associated with older age and give people more chance to plan.
Whilst expensive services may always be rationed, community-development based approaches such as Local Area Coordination show that access to support to think through non-service solutions need not be. The prevention group heard that there is no prevention and therefore no real savings without focusing on people’s abilities and potential, not just on their needs. It questioned whether there is such a thing as a preventative service, or whether it was more important that every intervention has a focus on reducing the risk of dependency. To do this, you have to think about the whole person, not just concentrate on one set of needs. For instance, aiming for a health intervention with a focus on NHS savings may well simply shunt costs to social care or housing, and vice versa, whereas looking at the whole person within the context of their relationships, family and community has a real chance of achieving outcomes, whilst also making a saving to the public purse as a whole. This made integration at the level of the individual (integrated outcomes frameworks, pooled budgets) and the community (jointly commissioned, home-based health, care and housing contracts) seem more important than structural integration.
You can read my blogs about the future of social care on the government website and elsewhere, such as this one for the Campaign to end loneliness in older age: Is ending loneliness a preventative service? http://bit.ly/vh7DqX
The government has said it wants the co-leads to stay involved in drafting the White Paper, so although the engagement process has officially closed, I remain, as ever, interested in your views.