I joined a plenary panel with CQC and DASS representation to focus on the quality and sustainability of social care. The question thrown to me by new President of ADASS Julie Ogley was great; she asked ‘what would NCF members have wanted the conference to hear?’
I talked of the need for us all to walk together; the battle wasn’t between commissioners and providers and great future care would only be achieved through partnership. But a real partnership between commissioners, providers, regulators, and of course people and citizens needing care now and in the future.
Of course, there is nothing I regret in those words. It is true this is what members want, and it is true that without this we will not be able to move forward.
Several battles being fought
However, ever since then, I have been mulling the ‘exam’ question, and I am struck not by the conversation in that conference room on that panel, but the many and varied conversations that are happening outside of the room. It is my use of the word battle I have fixated on, and I think what I really needed to say was – the battle is not between us but there most certainly is a battle going on. And it is a battle we all need to recognise and be part of.
The conference had heard a message from the Minister of Care the previous day that the Green Paper remained delayed. On the same day the Secretary of State for Health and Care stated in his evidence to the select committee that whilst it remained a source of great frustration to all that the Green Paper was not published, he could not provide any greater clarity to the committee that it would be delivered any time sooner than ‘in due course’.
Left now with a government that for a wide variety of reasons (almost all political with a large P) has chosen to suspend desperately needed debate on the future of social care for over two years, I think we most definitely are entering into a battle.
The problem to date is this has been fragmented across our various bodies. Providers have railed at the action of commissioners, commissioners have criticised providers, workers have shown anger at their employers, people using services have rightly challenged the efficacy, navigation, flexibility and responsiveness of a system that has person centred on the lid, but often something else inside the tin.
With the integration agenda firmly gripping the political spotlight, we have at times, appeared to create a new front for our battles. We have been decrying the lack of parity between health and care, calling foul on yet another announcement that seems to pour resources into the NHS whilst ignoring the needs of the social care sector.
In addition, we have begun to significantly segment our concerns. Some say funding is the critical factor, others the workforce and retention, others that we do not have the right models for now and the future, and of course that a good grasp of technology is what is needed. We have even taken to blaming the public for its lack of understanding of a complex system that we are all part of creating, and for not caring enough about the work we do.
We then seek to attack these different elements in isolation. Feeling perhaps a bit like government or indeed politicians across the piece, when we try to talk to the whole, we will lose our way or lose people along the way and therefore unravel.
Tackling the whole
However, tackle the whole we must. If we are not to get the sort of central guidance we have relied on, we must look to our constituent parts to come together. We need to build up a clear picture of just what resources we have available between us and work as allies and partners, not enemies and competitors. Some possible starters for ten:-
The ongoing delays to the Green Paper mean it will not be possible to deliver a meaningful response to the green paper that influences the Spending Review. Therefore we need to find ways to work together outside of that structure to coordinate a response.
The workforce strategy for the NHS is continuing apace. Again, we will be left in perpetual catch up without a single strategy for socialcare workforce. Ambitions to incorporate this in the green paper are likely to come too late. We need to act now.
The numbers of people left unable to access services continues to grow. We must work together as commissioners, providers and citizens to ensure that with one voice we make clear that one more person who is unable to access services is one person too many.
To build and grow the sector in a way that takes full advantage of the technological changes available now and in the future, we need to equip colleagues and organisations with the skills and expertise to come on board. However, in addition, we need to know that those who push the boundaries will be supported by a regulatory system that recognises the journey and embraces the vision for change.
Poll upon poll tells us that the public don’t understand care, that they are unaware of the cost of it, what it delivers and how they can access it.
Well, we need to turn our own statistics to our advantage.
Over 1.5 million people work in the care sector, 6 million plus people are carers, 1 million people are in receipt of some sort of formal care, another 1.4 million work within the health sector. In my mind, that is just under 10 million who will have a fair idea of what the sector does.
Working on the Kevin Bacon principle of 6 degrees of separation, that leaves us with almost everyone in the UK within striking difference of being connected with someone with a strong understanding of the care sector, so let’s get talking to them.
If there is nothing else we tell them about the sector, then give them this message #careaboutcare.