Making it happen: health, social care and devolution in the new Parliament

6 October 2015

It’s clear that, in order to sustain a comprehensive, high-quality NHS, action is required on three fronts: demand, efficiency and funding. Less impact on any one of them, Simon Stevens has said, will require compensating action on the other two.

We know the Government has committed an extra £8 billion a year, but that still leaves £22 billion to be found in efficiency savings and reductions in demand. How can the NHS possibly square the circle of substantially reducing demand from an ever-growing and increasingly vulnerable population? One thing is clear – it cannot do it alone. The solution has to involve the housing and care sector, and a much greater focus on prevention.

The role of the housing sector in healthcare is often misunderstood or underappreciated. We work every day with some of the most vulnerable and at-risk people in society. We have accrued that most valuable of commodities – trust. Many of the people who would most benefit from early intervention are resistant to approaches from statutory services and most likely to fall through the cracks.

We already have daily contact and solid relationships with these people. We can spot when people are at risk and, crucially, they’re more likely to trust us and be receptive when we try to help. And of course we have the facilities, or the capacity to build the facilities, to look after people without recourse to hospital admission, without people taking up a bed simply because they have nowhere else to go.

If we are to have a care revolution in the coming years, to meet demand and alleviate pressure on the NHS, housing with care providers will be absolutely key. But such a step change in provision is stymied at present by insufficient funding.

As someone who has worked in the care sector for more than 25 years, I welcome the National Living Wage and the beneficial impact it will have on many colleagues’ income, but there is an unanswered question about where the money will come from to pay for it. The Local Government Association calculates the National Living Wage will add £1 billion to social care costs by 2020.

Similar to the NHS five year plan, there has to be an acknowledgement that efficiency savings alone will not be enough. Such savings will be a critical component of any credible effort to make up the £22 billion deficit outlined by Simon Stevens. Without them, a sustainable future for the NHS is under threat.

We need to ensure more people get the most appropriate care at the most appropriate time, diverting them from chronic reliance on the health service. A failure to meet this challenge will perversely leave people unable to access even the level of care they currently do, at a time when it makes economic and clinical sense to increase access to care, not restrict it.

Doing the latter would only drive more people to NHS services that are more expensive and likely not as appropriate, convenient or effective as those the care sector can provide. Investing in care improves outcomes for individuals and saves money. It is a win win.

Rachael Byrne, Executive Director, Care and Support, Home Group
@byrnerae
@homegroup

This article was written for the Reform Annual Journal to accompany the Conservative Party Conference event “Making it happen: health, social care and devolution in the new Parliament”.

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