Insights

Mark Raeburn: 7 minute read

The recipe for the social care of the future; Innovation, agility and a dusting of funding

Let’s not lose sight of the fact that social care is on the brink of collapse and no short term funding will fix the situation; a typically risk-averse sector needs to recognise that sticking plasters are not enough. The good news is that the sector has begun to recognise this, even if the government has not and Local Authorities are taking practical steps to innovate.

Social Care Future is a good example of a movement of social workers that recognise new ways of working are needed. They recognise that the government is not going to quickly come to a decision on social care funding and even if they do, current models are not sustainable over the long term.

Social care is teetering on the edge and all it needs to do is stray but a little and it will be to the ruin of many. It needs a plan and a direction. The knock-on effects of a weakened social care system are evident, with hospitals and other frontline services picking up the bill. It is not the situation that we all dream of when we imagine our retirement, being picked up by the police after wondering the streets or being left in the hospital corridor.

All of this is not intentional of course. Doctors don’t arrive at work with the vision of leaving vulnerable individuals in the corridor whilst they await ongoing care but the reality is that there aren’t enough beds in the hospital at times. They were never built to be a care home.

The NHS’ responsibility is to get patients back on their feet and then send them on their way, whether that is to a home or back to their home. They should not be used as a halfway house whilst care is put forth for the vulnerable individual. Delays between health and social care are evident, with delayed transfers of care for example, which currently cost the NHS nearly a billion pounds per year.

What is the scale of the problem?

The Alzheimer’s Society has argued that a lack of appropriate care and care home places has contributed towards the rise of hospital admissions to those with Dementia. Looking at the increase in numbers we can see that an additional 100,000 people with Dementia ended up in hospital in 2017/18, compared with around 279,000 people in 2012/13.

This increase is costly not only in financial terms but also in terms of lives. For every day that an elderly patient spends in the hospital, they lose 5% of their body strength. Any delays when it comes to healthcare can be costly and none more so than when it comes to elderly patients. The sector needs a dedicated cash injection to breathe new life into proceedings lest those who are most vulnerable left to the side.

£1.5 billion is the figure that has been quoted by the government to meet rising demand and continue to stabilise the social care system. It is not enough and the Alzheimer’s Society agrees. They have gone on record to say that £8 billion is required to stabilise the system in addition to introducing free universal care. They are calling for social care to be funded like schools and the NHS.

What can be done?

At the simplest level, provide money. Money that can be used to stabilise the system and ensure its continued survival. This is the same process that the NHS seems to go through each year and helps keep it on life support. It is an option but rather than short term funding, we would like to see a long term funding plan and new ways of working agreed with stability for the future at the forefront.

In the first instance much like the NHS, we need to see more nurses trained and on the ground. According to a special Skills for Care report published last year, the number of nurses working in social care has fallen by 20%. To put an additional figure behind this, it is a reduction of 10,500 nurses on the ground.

For those with Dementia, there are currently only 279 specialist nurses or Admiral Nurses for the 850,000 people in the UK who live with Dementia. That is one nurse for every 3,047 people living with Dementia. A stark look at the statistics and one major area that needs investment as by 2040 there will be an estimated 1.6 million people with Dementia, nearly double what there is today. To help care for people with Dementia and their families a major change needs to occur or the ratio will increase to one nurse for every 5,735 people living with Dementia.

Money is needed but where it is spent is the key question. Those living with Dementia are needlessly admitted to the hospital each year and the cost associated with the admissions are increasing. It is one piece of the problem that is social care. A long term funding plan with a vision for the future is required and it is required urgently as without which, collapse is possible and no-one wants to see that future.

Can technology assist with the process?

Yes. We have believed this for the last 30 years and will continue to believe this for the next 30 years and beyond. Technology is the key component in which to unlock long-lasting savings for the benefit of everyone. We have created our ECLIPSE Software and Services Platform to be the embodiment of the overall change that is required.

The platform can work in isolation with its Bed Management software to alleviate the problems associated with Delayed Transfer of Care. With this component it can help to reduce the number of needless admissions to hospital, to get people where they need to be quicker. On top of this, it can be used for case management, multi-agency safeguarding, citizen engagement, commissioning, finance, transformation, security and data.

When used together all of these components can create the perfect ecosystem. An ecosystem that supports organisational innovation and agility. We also realise that a single component can make a great difference to an organisation. The point is that whatever stage of the journey you are on, something can be done and there is a technology solution out there to help with that need.

The NHS and social care need to work together, to share funding in order to make life easier for everyone. This is what we believe and whilst there are multiple problems between the two, with some needing one solution and others needing multiple solutions, the principle remains the same. Working together is key and technology can be instrumental in enabling this process for whichever problem is at hand.

Agile enough to tackle the future

Technology and funding will go a long way to reversing the trends that have glued themselves to social care over the last few years. To seize these savings a level of agility is required, much like a start-up organisation. A mind-set to encourage bravery in order to reimagine the future and redesign services. This is already happening in small clusters but the question remains as to how we mobilise and mainstream this innovation.

This was raised in a webinar put forth by The King’s Fund at the start of March. During proceedings, the panel discussed a multitude of ideas out there that can aid social workers in their day-to-day lives. The number of ideas is not the problem though. The problem is how to scale these innovations across the sector whilst battling against the tide of cuts to the budget.

Fear is restrictive and being brave enough to look at finances, placing money aside to invest in innovation is key. Yes, budgets are tight but by looking agilely at the problem and being brave enough to invest in new ideas and focus on the problems at your doorstep and not waiting for the government you can begin the process of change.

Sector-wide innovation is years away, with the Green Paper long lost to the winds of time, only to be spoken of in passing like some long lost treasure map. Courage to share good practice and innovations that have proven successful are what is required to begin the process of changing the present to improve the future.

What is the long-term outlook?

Bright. There are so many things that can be done, from increasing funding to testing new approaches to improving the technological infrastructure so that it can cope with new ways of working. The time for change is now but as it always comes back to in life, the money will be the gatekeeper to any real change. Investment is needed today, with a clear plan of action, or the price will be higher tomorrow. The longer we wait, the more expensive these changes will become.

In the short term, there will be a cost to any change, something that the Alzheimer’s Society is estimating to be in the region of £8 billion per year. This will be in addition to the introduction of free universal care in order to fund social care like the NHS and schools. It is a massive injection of money such as this one that is needed to tie health and social care together. It will be a big commitment for any government but one that is needed in order to continue caring for the most vulnerable members of society.

The acknowledgement of health and social care as one entity is something that has been needed for years. At the moment the additional funding that the NHS receives is swallowed up by social care. By listening to those calling for additional funding and the two to be joined together, you can put people first.

Short term funding is not the answer as that will only be lost within a year or so, leading you back to this position, with now £10 billion to find each year. With long term funding in mind, the outlook is positive and the costs will reduce over time. The training of additional nurses and having adequate care facilities available, tied together with technological assistance will create a new ecosystem. This will be for the betterment of those in care and the wider economy as jobs will be created.

To conclude
We can see that social care is on the brink and the evidence to back that point up is undeniable but then again, the system endures and continues somehow. It is on life support but through the dedication of those few who do work within care, it endures. It is still going on the whole but that does not mean that we should grow complacent. A long term funding plan combined with the tying of health and social care together is what is needed.

Wrapping all of this up with the introduction of technology will be the cherry on the cake. Change is available and the NHS’ move towards updating the technology that supports it is welcomed but by continually forgetting about social care, it will have reduced impact. We have said it before and will say it again, health and social care are two sides of the same coin and one will always bring the other down if not cared for.

Working together through the aid of technology is key to the future of health and social care. This is what will bring social care back from the brink and ensure that it has a bridge beneath its feet. This is the vision that we are working towards and why we created our ECLIPSE Software and Services Platform. We are proud of the work that we have undertaken to assist health and social care and will continue supporting them in order to create a unified future for the betterment of all.