14 Dec 2021
by The Homecare Association

A report released by the Nuffield Trust has concluded that over 20 years of reforms to better join up health and social care services across the four UK nations have made little difference to patients and service users, or the extent to which services are integrated.

Reponding to the report, Homecare Association CEO Dr Jane Townson said: 

“It is not surprising that efforts to integrate health and social care haven’t had the positive impact that is so desperately needed. Integration is ultimately meaningless without a change in culture and investment in all parts of the health and care system, including social care.

We are very much in favour of changes to the social care system and support integration. People receiving health and care services often report difficulty accessing the help they need and can feel pushed from pillar to post. We need to do better.

When we buy an aeroplane ticket, our key interaction is with the airline. As customers, we do not have to negotiate separately with air traffic control, ground control, pilots, cabin crew, the companies that supply food or fuel and so on, in order to travel to our destination. In health and social care, many of us find ourselves having to share our story with multiple different professionals in multiple different organisations.

To make the system work in concert, all key players need to focus on those needing support, communicate effectively with each other, and have parity of esteem. And it goes without saying that we need enough key players in all parts of the system in the first place.

Right now, the conditions to facilitate integration are not in place.

Social care providers, which employ the 1.54m strong social care workforce, do not even have a seat at the table.

Government investment in the care workforce has been inadequate for decades, leading to much poorer terms and conditions of employment than for equivalent skills in the NHS. So there is imbalance in the health and care workforce. In homecare, demand is outstripping supply, which is having serious repercussions for citizens as well as for the NHS.

Currently there are 1.5m hours of unmet care needs in England. Our strategy seems to be to neglect people in the community until they are in crisis, then blue-light them into hospital. Then it is the devil’s own job to get them out again because of a lack of capacity.

Rapidly growing waiting times for assessments and reviews, reduction in available safely staffed care services, and contract hand-backs, also add to pressure on the NHS. Inadequate capacity in social care risks harm to everyone needing medical help, as it contributes to ambulance queues, cancelled operations, and an increase in hospital waiting times.

Many careworkers love their roles as they can make such a positive difference to people's lives, and the relationships that develop between those giving and receiving care are invaluable.

We call on the government to invest adequately in homecare and community support, to grow and develop the workforce and innovate, so we can enable people to live well at home, extend healthy life expectancy, reduce inequalities, take pressure off the NHS and reduce costs for the health and care system.”


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