His speech ackowledged the pressures being faced by the system with:
- Many families finding it incredibly hard to access the care they want with or without means-tested support from the state.
- Many people employed in the system finding themselves, working too hard as they struggle with fragmented services coming under unprecedented pressure.
- The CQC expressing serious concerns about the state of the adult social care market and the risks of provider exit.
- Pressures trickling down to the NHS with A&Es becoming overcrowded because hospitals find themselves unable to discharge patients who cannot access social care support packages.
Setting the scene Jeremy Hunt commented "Behind these systemic issues sit many ordinary human beings in a great deal of distress. Families coming to terms with a relative with dementia. Older people living on their own who won’t admit they are lonely. Care home residents with clinical depression, as we know happens in 4 in 10 cases."
The 7 Key Principles
1. Quality
81% of adult social care providers are good or outstanding according to the CQC. But still too many people experience care that is not of the quality we would all want for our own relatives. There will be a commitment to tackle poor care with minimum standards enforced throughout the system.
81% of adult social care providers are good or outstanding according to the CQC. But still too many people experience care that is not of the quality we would all want for our own relatives. There will be a commitment to tackle poor care with minimum standards enforced throughout the system.
One of the questions the Green Paper will pose is whether we can build on the learning from the introduction of independent Ofsted-style ratings for providers to spread best practice to commissioners as well.
2. Whole-person integrated care
The risk is that too often an individual and their family are passed from pillar to post, giving the same information repeatedly without receiving joined up, personalised care that makes them feel like a valued human being and not just another task on someone else’s to do list.
Users of the social care system should have just one plan covering all their health and social care needs based on a joint assessment by both systems.
The risk is that too often an individual and their family are passed from pillar to post, giving the same information repeatedly without receiving joined up, personalised care that makes them feel like a valued human being and not just another task on someone else’s to do list.
Users of the social care system should have just one plan covering all their health and social care needs based on a joint assessment by both systems.
New pilots in Gloucestershire, Lincolnshire and Nottinghamshire will see every person accessing adult social care given a joint health and social care assessment and - critically - a joint health and care and support plan, where needed.
3. Control
What matters to individuals and families is the ability to direct the care they receive and autonomy to lead the lives they want. Whilst over 90% of older people receive some type of self-directed support, only around 1 in 6 take it as a direct payment with take-up stubbornly low for older people.
What matters to individuals and families is the ability to direct the care they receive and autonomy to lead the lives they want. Whilst over 90% of older people receive some type of self-directed support, only around 1 in 6 take it as a direct payment with take-up stubbornly low for older people.
The government wants to "turbo-charge" progress on integrated health and care budgets, making them the norm and not the exception when people need ongoing support.
Over the next 2 years in Gloucestershire, Lincolnshire and Nottinghamshire every single person with a joint care plan will also be offered an integrated health and care personal budget.
4. Workforce
Talking about workforce issues Jeremy Hunt said "People who work in care homes, who do home visits, who look after people with care needs with kindness and love in every street in every town – these are our society’s modern-day heroes. Often highly skilled, they are typically also the lowest paid."
"So it is time to do more to promote social care as a career of choice and to ensure there are better opportunities for progression into areas like nursing which span both the health and social care sectors. And we need coherent workforce planning that is better aligned with that now being undertaken by the NHS. Alongside social workers, occupational therapists and nurses in social care we have many care workers who could benefit or be inspired by new progression ladders similar to those that are being developed in the NHS including roles such as associate nurses and nurse degree apprenticeships. These must be as available to those working in social care as in the NHS."
"We have many registered professionals including social workers, occupational therapists and nurses in social care; and many more care workers and other unregistered professions. We need to ensure we have enough people within all of these skilled roles to support people to live the best possible lives. That means making sure that the new routes in to professions that we have developed for those working in the NHS, and the new roles such as nurse associates, also work for those wanting to build their careers in social care."
"We need to recognise that people move between the NHS and social care systems - and will do more so as the 2 systems join up. So part of our thinking must be to think about health and care workforce issues in a joined up way. I can therefore confirm today that later this year we will not now be publishing an ‘NHS 10 year workforce strategy’ – it will be an ‘NHS and social care 10 year workforce strategy’ with the needs of both sectors considered together and fully aligned."
5. Supporting families and carers
Jeremy Hunt said "If we can make it simpler to look after a loved one, if we can make it easier to juggle working and caring responsibilities, if we can encourage volunteering – whether by more flexible working, better employer support or harnessing new technologies, then that is what we should do."
"Over the past months we have been listening to the views of carers so ahead of the Green Paper we will publish an action plan to support them."
Jeremy Hunt said "If we can make it simpler to look after a loved one, if we can make it easier to juggle working and caring responsibilities, if we can encourage volunteering – whether by more flexible working, better employer support or harnessing new technologies, then that is what we should do."
"Over the past months we have been listening to the views of carers so ahead of the Green Paper we will publish an action plan to support them."
6. A sustainable funding model for social care supported by a diverse, vibrant and stable market.
The government will look at how it can prime innovation in the adult social care market, developing the evidence for new models and services, and encouraging new models of care provision to expand at scale.
Specifically looking at the role of housing, including how the very best models that combine a home environment with quality care can be replicated and how we can better support people through well-designed aids and adaptations.
The government will look at how it can prime innovation in the adult social care market, developing the evidence for new models and services, and encouraging new models of care provision to expand at scale.
Specifically looking at the role of housing, including how the very best models that combine a home environment with quality care can be replicated and how we can better support people through well-designed aids and adaptations.
7. Security for all
Families are too often faced with the randomness and unpredictability of care, and the punitive consequences that can come from developing certain conditions over others.
If you develop dementia and require long-term residential care, you are likely to have to use a significant chunk of your savings and the equity in your home to pay for that care. But if you require long-term treatment for cancer you won’t find anything like the same cost.
People’s financial wellbeing in old age ends up defined less by their industry and service during their working lives, and more by the lottery of which illness they get.
Families are too often faced with the randomness and unpredictability of care, and the punitive consequences that can come from developing certain conditions over others.
If you develop dementia and require long-term residential care, you are likely to have to use a significant chunk of your savings and the equity in your home to pay for that care. But if you require long-term treatment for cancer you won’t find anything like the same cost.
People’s financial wellbeing in old age ends up defined less by their industry and service during their working lives, and more by the lottery of which illness they get.
The system needs to includes an element of risk-pooling and the government will be bringing forward ideas as to how to do this alongside the potential costs in the Green Paper.
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