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The Future of Social Care

Power and Corporate Politics

Change and the Shadowside

The Future of Social Care

By Wyn Williams

On July 14th 2009, the government published its long-awaited green paper on the future of adult social care.  The paper highlights key challenges and problems with the current system, outlines a vision for care and support and explores a number of alternative funding models to ensure the future system is affordable and sustainable.

The Current System

The paper summarises the challenges and problems of the current social care system, these include:

  • The perception that the current system is unfair particularly from those people who have worked all of their lives and find that they do not qualify for financial support in meeting their care needs.
  • The inequality that arises from the different interpretations of eligibility criteria in different parts of the country leading to a ‘postcode lottery’.
  • The confusion people experience in trying to access social care acknowledging the difficultly in getting a clear answer on what help someone is entitled to and how much it could cost. 
  • The concentration of resources on those with the highest needs which means that not enough funding is directed toward prevention and reablement activity.
  • The fragmented nature of the system with the service user having to navigate through the NHS, local authority, housing organisations and the benefits system.
  • The legacy of services built around the needs of the provider rather than the service user.
  • The demand led pressures that the system is facing due to the aging population.
  • The changing expectations of service users who expect higher standards and much greater choice than previous generations.

The vision for care and support

The paper goes onto outline a new vision for care and support system in England built on the following themes:

  • Prevention: Getting the right support early enough to help people stay well for longer so that their care and support needs do not get worse and can remain independent.
  • National assessment: Receiving the right care and support wherever you move to in England.  The foundation for this is each person being assessed in the same way and ensuring that the same proportion of care and support costs are paid for wherever you live.
  • A joined-up service: All the services working together to support individual needs with social care, health, housing services and the benefits system better integrated.
  • Information and advice: The care and support system should be simple and easy to navigate with help and information and information accessible and available to all.
  • Personalised care and support: People will be able to live their lives in the way they want, supported by the services that they choose with a system that gives local authorities the space to innovate, encourages services to respond to local conditions and delivers true personalisation.
  • Fair funding: Money should be spent on high-quality and cost effective services with the private, public and third sectors delivering care and support.
  • More joined-upworking:  Better joined-up working between health, housing and social care services and between the care and support and benefits systems to help people live at home longer.  
  • Wider range of services: Offering a greater choice over the care and support they receive and the range of support available.  
  • Better quality and innovation:  Services based on the best and most recent information about what works in providing care and support.

Funding options

Five models of funding care and support are appraised in the paper with three of these being offered for further exploration and consultation, these are:

  • Partnership– In this system, everyone who qualified for care and support from the state would be entitled to have a set proportion of their basic care and support costs paid for by the state. People who were less well-off would have more care and support paid for while the least well-off people would continue to get all their care and support for free. 
  • Insurance– In this system, everyone would be entitled to have a share of their care and support costs met, just as in the Partnership model. But this system would go further to help people cover the additional costs of their care and support through insurance, if they wanted to.
  • Comprehensive– In this system, everyone over retirement age who had the resources to do so would be required to pay into a state insurance scheme. Everyone who was able to pay would pay their contribution, and then everyone whose needs meant that they qualified for care and support from the state would get all of their basic care and support for free when they needed it.

Five things you can do now to help prepare for the future:

  1. Map what proportion of your resources are currently focused on prevention and reablement.  Do you feel this is the right balance?  Could you do more in this area?
  2. Look at the NHS world class commissioning standards.  How well do you feel you meet these?  What could you do to build commissioning capability?
  3. Review your care management processes and approaches.  How could these be improved?  Can you do more to promote self-directed support?
  4. Think about how you currently provide information about your services.  How could this be improved?  Can you work with partners on this?
  5. What can you do to build greater choice for service users?

If you have any questions about the subjects covered in this white paper or you would like to find out more about how Oakleigh Consulting could help your organisation, please contact us on 0161 835 4100 or email us.


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