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Prevention must be at the heart of the Green Paper

Posted by: , Posted on: - Categories: Care and support, Innovation

In his latest blog for Social Care News, Ewan King, SCIE’s Director of Business Development and Delivery makes the case for placing prevention at the heart of the new Green Paper. Investing now to relieve the pressure on social care is important, he says, but not at the expense of longer term solutions to delivering sustainable, high quality services…

Ewan King: 'We need to fundamentally change how we measure and incentivise the health and care system.'

Dealing with what is right in front of you - the here and the now - is a natural human response. As for longer term thinking - well perhaps that comes later.

And right now, faced with real pressure, there is a strong case for social care leaders to focus on the most immediate issues: too many people stuck in hospitals, and a collapsing care market.

That means investing in immediate solutions to alleviate the pressures on hospitals, including if necessary propping up struggling care providers. There is a danger here, however, that whilst we sort out immediate problems we might neglect to think about the potential long-term future of care.

Given more time, and additional investment, there is broad consensus that a different approach is needed. Alex Fox of Shared Lives Plus and a SCIE trustee argues that we need to invest in innovative, preventative, new models of care, not just safeguard struggling existing models.

He maintains that: “A narrow focus on what forms of social care will immediately alleviate the current pressures in the NHS will not ultimately achieve its goals. The models which work are those which are... built around goals like wellbeing, independence and resilience.”

Prevention spend

The trouble is that as money has tightened - and despite all the good practice out there - we have sometimes struggled to invest in preventative services. There is agreement that increasing the focus on prevention can release savings in the future, increasing independence and limiting the need for more expensive ongoing care. Yet, according to ADASS, spending on prevention has greatly reduced in recent years.

Thankfully, templates already exist for how preventative models can work. These include models like village agents, community circles, local area coordination and social prescriptions, all of which have shown that community-based preventative models can save money whilst helping more people maintain their independence.

One such model - care navigation - developed as part of a new model of care on the Isle of Wight - involves care coordinators assessing the holistic needs of people and supporting them to access a range of support services which boost their confidence and independence. Independent evaluation estimates that cost savings of £553k (ROI 53%) per annum (through reductions to the use of services) have been achieved whilst increasing people's well-being.

Time to scale up

Even though the Care Act 2014 sets out a vision for more preventative approaches that build on people's strengths, these models are yet to be scaled up. They need to be now. The alternative is a future that includes quick fixes and work-arounds that will probably lead to poorer quality outcomes.

Prevention needs to be at the heart of the proposed social care green paper. New money will be part of the solution, as the very best preventative models need investment in order to grow. Budgets are too stretched right now to pump prime new innovations.

But we also need to fundamentally change how we measure and incentivise the health and care system, for instance by finding better ways to reward areas that demonstrate significant increased investment in preventative models of care.

Social care, to be fair, has got better at responding to these challenges. It has had to. But with the right kind of policy framework and underpinning funding, the sector can also become even more adept at developing preventative models of care that deliver for the longer term.

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  1. Comment by ian posted on

    It's hard to know how reducing the number of daycare places (characterising local authority practice over recent times) is a cost-effective approach to social care? Or is it just my London borough?

  2. Comment by j posted on

    bring back proper convalescence homes;
    have mandatory training for all the low paid workers who are classified as “carers” in care homes, and in people’s homes.
    At present, it is a shambles,and leaves vulnerable people in great danger of neglect and abuse. Most of the time spent in private homes is taken up in paperwork and travelling.

  3. Comment by Pearl Baker posted on

    Social Workers training in it's present form leaves too many 'gaps'.
    'Holistic' needs? you first must understand what this means? my client and her mother was unable to get help for two years/ living mostly on the streets, suffering from Schizophrenia/stoma 'bag' often no Support by anybody, all of them useless until the Police 'picked' her up, now under section.

    My new client of yesterday: Carer, and Suffers from Mental Illness, looks after Severely Autistic 27 year old son. This Carer/Sufferer cannot get help from anybody, (All say it is NOT us) been informed will both have their DLA/PIP removed as they are NOT Supported by any Agencies?

    The Care Act 2014 is more than useless. It says Carers have Legal Rights? i would like anybody to challenge a LA, who have their own ideas on this. (because i have) 'Needs assessment' never implemented by this LA, as an un-recognised Carer I do everything, last evening cleaning and laundering cloths at 8.30 in the evening.

    Personal Budgets, Choice of your Provider are just WORDS you will never EVER have your OWN Wishes to be in Control of your Life in the Community, for MOST you have exchanged a Hospital Institution to a Community Institution.

    I am a CARER of thirty years i know the system, all the above is correct. PHSO complaint has been sent regarding DWP failure to understand their own System. ATOS complaint in their failure to understand Carers rights, and the DWP system.

    It is NOT just about knowing one part of the JIGSAW you must know how other Agencies 'link in' to each other.

    The LGO have already upheld a COMPLAINT against a LA, and will be USED against ATOS.

    SCIE are out of their depth, you need the help of an 'Expert by Experience' otherwise i will be working until i die?