What does the social care sector need from academia? There has long been a gap between what national government says about the need for social care to achieve and evidence outcomes, and the reality of the kind of basic functional support that local government can and will buy. This gap has widened during austerity to and is now unbridgeable without significant additional funding for councils to provide adequate social care.
There is no ‘neutral’ position for academics to take on this. Do they look for outcomes which are set out in legislation but which many services, particularly for older people, are not asked or paid for and do not attempt to achieve? To whom do they ascribe blame for the gaps and failures they will surely find: hard pressed, underpaid frontline workers, providers which teeter on the edge of financial viability, local government commissioners who lack the money to buy what people need, or central government which has devolved spending decisions to the local level? Those are political judgements.
Funding bodies and the institutions which bid to them put the majority of their resources into researching the most prevalent models. That is pragmatic – those models offer large sample sizes and are the most significant budget lines in council and NHS budgets – but it also ensures that the evidence base for traditional models strengthens, whilst innovative models like Shared Lives, Homeshare, Community Circles, Time Credits or Local Area Coordination are locked into an endless cycle of small scale qualitative research which finds them to be promising but unproven. This in turn entrenches risk-averse procurement on a ‘better the devil you know’ basis: certain kinds of predictable failure look less career-threatening to commissioners than the possibility of success, particularly where ‘success’ would mean outcomes valuable to people but not valued by the broken economics of our health and care system.
I am honoured to be joining Birmingham University as an honorary senior fellow. Birmingham University’s school of social policy has the mission ‘to change the world as well as to understand it’ – as 2017 draws to a close, it feels like the world has never needed changing more.
This is an extract from my blog for the university: https://www.birmingham.ac.uk/research/perspective/academic-decisions-for-social-care-sector.aspx