The UK cannot escape the challenges that are being placed on both social care and NHS systems from an increasingly elderly population.
We need to recognise that current systems of care are fragmented and do not provide easy access to clients when in crisis, are based on models of acute hospital care which do not reflect the needs of an ageing population and are process driven which does not encourage risk pooling or service integration.
Maintaining the status quo is not an option. At a recent Reform seminar Andrew Dilnot, Andy Burnham and eight eminent commentators and academics commented that there cannot be many major areas of social policy where there is such widespread agreement about the nature of the problem, but such inertia against acting now.
The difficulty comes in knowing what to do about it, especially when the bottom line is that much more money will be needed to make things fairer.
The UK’s social care and health systems must embrace the challenges faced from an increasingly ageing population and collaborate now to transform a care system which does not meet the demands placed on it.
The solution lies in public and private sector bodies working more collaboratively with improved engagement with families and carers in the design and implementation of solutions that work for them. The key actions highlighted at the seminar include:
1. Breaking down the false distinction between physical care, social care and mental health. Care for individual’s needs holistically and see the client as an individual with individual care needs - which must be met by the care system
2. Considering the case for a large-scale re-distribution of public spending - with £50bn spent on provision of over 65s acute hospital care for patients with chronic conditions who could potentially be treated closer to or at home and only £8bn on social care, there is real scope for redistribution.
3. The current generation of older people has benefitted from home price increases and are sitting on £250bn of releasable equity that could contribute towards their care costs – but there must be a simple and reliable method of accessing capital, for example improved access to equity release schemes.
If the recommendations of the Dilnot Commission are adopted this year, older people may be protected from the worst effects of high care costs.
Change will not just take place through the adoption of Dilnot. System commissioners and providers will need to change behaviours, pool budgets and engage with clients in new and innovative ways.
Only through system change will the required £2.2bn to £3bn (a redistribution which should come from acute hospital care provision) of funding be found and re-directed towards social care. Older people who are currently ineligible for funded social care may be entitled to payments and consequently local authority adult care departments need to be prepared for the increase in workload this could create.
Political leadership of this change will be imperative at both a national and a local level. Politicians must discuss the shortcomings of the current system openly and promote system change. Society in general needs to engage in the debate and recognise that we will all face choices in our older age and that we have a responsibility to plan effectively for it now.
Steve Carefull is a healthcare expert at PA Consulting Group.
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