Dogs bark. Cats meow. Local authorities complain about not being given enough money from central government.
Among the reactions to the Autumn Statement from the “sector” was the following comment from Liam Booth-Smith, Chief Executive of Localis:
“Social care’s absence was worrisome, and with the living wage increase helping many care workers (itself a good thing), the financial pressure will increase. I can see how many in local government find this underwhelming if not downright upsetting. And yet here we are. Like Camus’s Dr Rieux we must acknowledge what we see, even if it defies our sense of logic. The chancellor has sent a pretty clear message; ‘find the money somewhere else’.
“There’s some unfortunate politics in all this; the majority don’t use social care services and many of those who do don’t acknowledge it as such, so for the time being government seems prepared to let councils figure this one out for themselves.”
So how are local councils to “find the money somewhere else” for adult social care?
There is lots of talk about integrating services with the NHS. Conservative-run Bath and North East Somerset Council has come up with a bold plan to make it a reality. The BBC reports:
“A £700m contract to provide community health and care in Bath and North East Somerset over the next seven years has been approved for Virgin Care.
The council said it was “an exciting new chapter in the integration of health and care services”.”
Cllr Vic Pritchard, from Bath and North East Somerset Council, said:
“Local people can look forward to a more joined-up and personalised service in the future, with the focus firmly on prevention and supporting people to maintain their independence.”
The “joined up” arrangements between the Council and the NHS are regarded as necessary to keep costs under control – “if we carry on running services in the same way as we do now then we will run out of money” is the blunt message from the Council and the NHS. However the case is also made that by sharing information and improving the technology there will also be an improved service:
“People told us they want more care closer to home. Virgin Care will organise their services around GP practices so that people have access to a wider range of health and care professionals in their local community to improve the health and wellbeing of the community.
People told us that the separation between different services can make it harder to get the right support. Virgin Care plan to set up a care coordination centre so you only need to speak to one person to access all the services that can help you.
People told us they only want to tell their story once. Virgin Care have tried and tested technology that will join up both health and social care records securely so that everyone involved in a person’s care and support, including the person themselves, has access to the information they need.”
The full Business Case adds:
“The core functions for Virgin Care will include connecting services and integrating person-centred care and support that is co-ordinated around an individual’s needs, wishes and preferences. Service provision will focus on the whole person, focusing on their strengths, interests, abilities and networks, not just their diagnoses, illnesses and deficits. Support will be built around individual preferences and choices and helping people to help themselves.”
This is controversial, of course. There are the ideological objections to private sector involvement – although it may well be that this is crucial to making a reality of integrating the services. I’m not a great fan of Sir Richard Branson and it would be welcome for competitors to Virgin Care to come forward with their own innovative ideas to pitch for these contracts. However the Bath and North East Somerset scheme does seem to have been carefully considered. The consultation has been genuine. If they succeed then many others may follow.