New principles of care

By Ewan King | 11 April 2018

Jeremy Hunt’s first speech as Secretary of State in the new Department of Health and Social Care had a lot to commend it. He outlined the seven key principles for social care reform, which include a focus on improving quality, giving people who use services more control, and integrating care around the individual. He also announced a much needed 10-year joint NHS and social care workforce and a £1m pilot to ensure all users get joint health and social care assessments and care plans.

In his speech on World Social Work Day, Mr Hunt reminded listeners that Britain has a proud pedigree in establishing one of the first comprehensive healthcare systems in the world, and that our innate sense of decency, kindness and common humanity will drive us to the right solution for social care. But, he also said the NHS is coming under increased pressure because of delays caused by social care. He recognised, too, that to get this right feels an enormous burden on his shoulders.

A key principle

So, how do we use that legacy the NHS has given us to square up to these challenges? One of the seven principles the Secretary of State mentioned is to provide whole person, integrated care with the NHS and social care systems operating as one.

In addition to giving people a single health-and-care assessment and personalised plan, one area of significance he highlighted was the provision of access to personal health budgets. But why is this so exciting for social care?

Well personal budgets can improve people’s quality of life and wellbeing. In some areas, personal budgets are a central feature of the development of a far more person-centred approach to care and support. But our evaluation of Integrated Personal Commissioning – which is seeking to significantly expand the use of personal budgets – also found that risk aversion, especially in the NHS, can prevent people from having greater choice over the kinds of services they receive.

We also know that strong relationships with the voluntary and community sector are essential to create innovative services people want to purchase with their budgets, as well as to provide good support that will enable people to make the most of their budgets.

Co-production and personal budgets

There will be a consultation to extend rights to integrated personal budgets for those with the greatest ongoing social care needs, so that more control can go into the hands of people who use services, family and other carers. This is vital because, for some time, we at the Social Care Institute for Excellence have been saying that service users and carers must have a strategic role in implementing integrated approaches between health and social care, including how personal budgets are made available and, of course, in shaping a market of high-quality providers of care and support locally. We call this co-production and the tone this approach is setting across the national and local political spectrum is encouraging.

Of course, there’s more that can be done. We’re working with Oxfordshire CC to embed co-production in many of their processes for delivering adult social care, and we would love to speak to other local authorities to see if we can support them. But, as I say, the soundings are encouraging.

In his speech, Mr Hunt called for ‘a partnership between the state and individuals’ and said that we need to scale up much more innovative ways of delivering care, so they are available to more people. Personal budgets can make a great contribution to integrating health and care, and in improving people’s lives. The challenge will be making this happen.

Ewan King is director of business development and delivery at the Social Care Institute for Excellence

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