Insights

Mark Raeburn: 5.5 minutes

The NHS and Social Care - two sides of the same coin

The NHS and Social Care are two sides of the same coin. We have been saying this since day one. Since 1991 and the day that we first opened our doors, the NHS and Social Care have existed as two separate entities. We have never agreed with this stance but by that same token, we do not agree with supposed proposals from the government that the NHS should take control.

The historic viewpoint

Looking back to the past and we can see that Social Care is a key service, in the same way, that the NHS is. In their modern incarnations, both entities can trace their origins back to the conclusion of the Second World War. The global conflict spurred the nation forward to create reforms which make life easier for those in the poorer parts of society.

Both entities have been created to make life easier for those in the poorer parts of society. Since day one, the NHS has taken the lead in the public’s eye, it has claimed the headlines and become the vote-winning goliath that it is today. Social Care has continued under the public radar, operating with almost stealth-like precision, whilst the NHS has written the speeches.

Deep down, both services care for those who are vulnerable, neither should be perceived as being more important than the other. This is not how society has seen the situation and heralds the NHS above all. This is the historic viewpoint and there are signs that the winds are changing, with the Covid-19 pandemic changing hearts and minds.

The Coronavirus Pandemic

We are all aware of the current global pandemic. This is not news. We are all transitioning as a society, from one that lived on top of each other, relishing face to face contact, to one that lives apart. Today we are required to keep our distance to protect those who are vulnerable. We are asked to keep them in our hearts and minds as we move away, help them to shield and ensure that the NHS and Social Care can continue functioning.

Throughout this process, we have been asked to stand away from relatives and those in care homes, which has meant little face to face contact. Through this, we have seen the gaps appearing, and public perception beginning to change. The Social Care crisis is viewed as that, a crisis and one that the public is interested in.

The government has also seen through the current crisis that the situation can no longer be ignored. We are in a time of crisis and the weaknesses between Health and Social Care need to be addressed. Hospital discharges have been prioritised and this is where the gaps are evident. Problems with delayed transfers of care have plagued the two entities for years and when your priority is to discharge people as quickly as possible, you notice existing problems in greater detail.    

Taking control

In a way, it is sad that it has taken a global pandemic to highlight to the government the importance of Social Care, but it has, and full advantage needs to be taken. We need to learn lessons from the pandemic. The first of which is that too much bureaucracy is not good. This seems simple enough and should never have been an issue, but it has been.

Matt Hancock referenced this red tape in a recent speech to the Royal College of Physicians about the future of healthcare.

“So today I want to start a conversation about how we can put these values into action. How we can capture a culture that lets our carers care. And scythes away the red tape, attitudes and ways of working that stand in the way.”
Gov.co.uk, Matt Hancock speech

Mr. Hancock went on to talk about ‘seven major, cultural lessons that I think we’ve all learnt over the past few months.’ The key lessons that Mr. Hancock presented were related to working collaboratively, reducing red tape and embracing innovation. We agree with these, especially with the thoughts behind utilising technology to enhance multi-agency working. What we do not agree with is the NHS simply taking control of Social Care, which was an idea that recently grabbed headlines.   

What will happen?

If we could predict the future, then the lottery would be the number one consideration for most of us. What will happen in a year, a month or even a week is, unfortunately, not available, and we need to rely on experience to guess what might happen?

The supposed, leaked reports that outlined plans for the NHS to take control of Social Care created a storm online. They have not been verified by Downing Street, but, where there is smoke, there is fire.

The Guardian published in its article that,

“Social Care could be brought under the control of the NHS in England in a controversial move that would cause the health service’s budget to soar to £150bn, the Guardian has learned.

Downing Street has drafted in David Cameron’s former policy chief Camilla Cavendish to help finalise proposals designed to honour Boris Johnson’s pledge to “fix the crisis in Social Care”.
The Guardian, Revealed: NHS could take over Social Care, swelling budget to £150bn

We can all look back and remember that Boris Johnson, on his first day as Prime Minister, promised to fix the Social Care crisis,

“And so I am announcing now – on the steps of Downing Street – that we will fix the crisis in Social Care once and for all, and with a clear plan we have prepared to give every older person the dignity and security they deserve.”
OLM Systems, Will Boris Johnson be able to keep his Social Care promises?

From this point, we have seen the finalisation of Brexit going through Parliament, devastating storms and Covid-19. It has been a challenging year for the Prime Minister, to say the least. He has also spent weeks in hospital after contracting Covid-19. Throughout all of this, he has seen the challenges that Health and Social Care are going through, all of which have been accelerated during these troubled times.

Given that he made this one of his first pledges when he stood on the steps of Downing Street, we would believe that he would want to be seen to prioritising this issue. To emerge with a solution, despite everything and his declining popularity, would showcase him as a man of his word. He would also be seen as someone who prioritises the people despite the economic situation.

Do we agree?

We completely agree with the core mission of ‘solving’ the Social Care crisis but to use it for political gain? This is where we disagree. Social Care as an entity cares for thousands every year. They are heroes in every sense of the word, and every bit the equals of their NHS counterparts. They know what they are doing, they have simply been deprioritised in comparison to their older sibling, the NHS.

We believe that the two should work together more closely and be considered as one entity, but to have one control the other is wrong. The political message here is that, ‘the NHS is resilient and through this crisis, we have seen this, so we are giving them control of Social Care. The NHS will help them get on the straight and narrow.’

This is the message that we see being conveyed by the Prime Minister. He could look to further empower the NHS and project to the public that the ‘crisis’ was caused by Social Care. They would, therefore, be seen as not being able to control their finances. This is not true but the political messaging would be powerful.

We disagree and believe that both entities, following on from the red tape being cut, have performed admirably. The problems have come from the government. What we need now is a comprehensive plan for Health and Social Care that empowers those who work within to continue caring. Both areas know what they need to do and now is the time to be trusted to do so, with technology bridging the gaps and enabling true, integrated care.

To conclude

The NHS and Social Care are two sides of the same coin. They exist separately but need to exist as one. This is a plan being supposedly considered by the government. We fully endorse it but do not agree with the idea, shared by newspaper insinuations, that the cabinet is considering giving the NHS control of Social Care.

The current pandemic has brought to life many opportunities. The most important of these is the ability to make quick decisions. This has been something that both entities have been screaming for over the last decade. The pandemic has loosened restrictions and changes have appeared quicker than they ever would have been in the past. This is something to be kept.

We believe in tying the two organisations together with a joint funding plan but giving one priority over the other seems like a political consideration. We need joined-up working and not one entity dictating what the other can do. It would simply be the equivalent of swopping one level of bureaucracy for another.

This is the time for a change and to work closer together, but it is not the time for the NHS to take control of Social Care.