British Red Cross welcomes budget announcement
Mike Adamson, chief executive of the British Red Cross has responded to the social care announcements made in the Budget.
In the early days of the new year, the British Red Cross did something which many considered unusual. We spoke out in strong terms about the very human crisis we were bearing witness to in the health and social care system in the UK.
One of the reasons our message caused people to stop and take notice, we came to understand, was because people associated us with providing humanitarian aid overseas and not with our work supporting the NHS in this country. In fact the British Red Cross has been working alongside the NHS since it started in 1948, which is how we knew that the pressures on the system – in a large part due to a lack of social care - were becoming intolerable for many.
Two months later the debate has evolved considerably. There is now widespread acknowledgement of the problem that a lack of proper social care is placing on the health system in some areas, and the significant impact that has on peoples' lives. For them this can feel like a frightening and very personal crisis. The Chancellor’s announcement on Wednesday of new money and a strategic review of the system is hugely welcome.
For too long our social care system has been treated like the NHS's poor cousin. In my experience many people are often unsure about what social care is, let alone how important it is. Having worked in the sector for 20 years and seen the difference effective care and support makes, I am determined that this must end and that much more value must be placed on it. Practical support for illness, disability or old age not only enables people to continue living in or closer to home, it helps them to carry out basic and essential human activities: getting out of bed, going to the toilet, eating and drinking. It prevents them getting ill and radically improves quality of life.
The £2bn the chancellor announced will ease the pressure on the social care system over the next three years. It will help ensure that local authorities do not have to make further service reductions and that society's most vulnerable receive the care and dignity they deserve.
As the pressure on our social care system eases, so should the pressure on our hospitals and NHS. The interdependency of health and social care has never been more visible. Delayed transfers of care from hospitals due to social care have risen by 65% since 2011.
However, in reality the £2bn is not enough to address the impact of successive service cuts or even address current levels of unmet need. With £4.6 billion of cuts to social care funding between 2010 and 2015, 1.2 million older people are estimated to have unmet needs for care and support and at least half a million fewer people are receiving care compared to ten years ago. This is despite an increase in demand. Any additional money beyond stabilising the system should go towards providing quality care to those who are not currently receiving support despite being eligible under current criteria.
The Chancellor has recognised the need for a longer-term strategic plan. This could be profoundly important. The problems we are seeing in health and social care are not simple to solve but we must take this opportunity to rethink how we approach them.
Our needs are complex and so are our systems. We must begin to view people as whole individuals, rather than ‘patients’ with a bundle of needs. As we live longer with increasingly complex conditions, such as diabetes, chronic obstructive pulmonary disease, dementia, high blood pressure, it's becoming increasingly difficult to distinguish between 'clinical' and 'social' needs.
Having two separate systems is outdated. With plans to integrate health and social care by 2020, this is widely recognised. Yet, effective integration will not materialise just because we want it to. With one system (the NHS) funded centrally and free at the point of access and the other (social care) funded locally and means-tested, we seem a long way off full integration.
The strategic review must also do more to focus on prevention. We will only help prevent people reaching health and social care crises by providing care and support to people with lower level needs. The Care Act 2014's prevention duty already sets out measures towards this: seeking to intervene early, helping people retain or regain skills and confidence, preventing need in the first place and delaying deterioration wherever possible.
Small interventions can make a big difference. British Red Cross support at home services undertake such tasks such as checking somebody's fridge is full when they return home from hospital, making small adaptations to somebody's home so they can carry out tasks independently or attending a community group to reduce loneliness and social isolation can help people live fulfilling and not just long lives. Our mobility aids services ensure that people have access to a wheelchair so that they can keep active whilst they are recovering from a trip or fall.
Disappointingly, the Care Act's prevention duties and responsibilities have so far not been fully implemented on the ground. Councillors have reported difficulty determining which services are actually preventative. More needs to be done to facilitate the sharing of good practice. And, with overstretched funds local authorities have struggled to meet their statutory duties, let alone go above and beyond and invest in services that prevent, reduce and delay. In fact, despite identifying increased prevention and early intervention as the top area for savings, local authority spending on prevention has reduced since this piece of legislation came into force.
Finding a solution to these problems will take time and will need politicians from across parties, health and social care professionals, charities and service-users to work together. Today's move by the Government is no doubt a step in the right direction. We stand ready to play our part in building a social care model that more effectively bridges the gap between health and social care and prioritises preventing people from falling into health and social care crisis.
I don’t think any of us have a choice but to address these problems. As people live with more complex conditions and our population continues to age, the public will become increasingly aware of the need for these types of services. Some of us may know of someone who does not eat regularly enough because they cannot get to the shop to buy food. They may know someone who chooses not to drink enough because getting to the toilet is too difficult. They will know of elderly people who do not get enough rest as they struggle to look after their vulnerable partners, or of a colleague desperately trying to secure the right support for their parent so they can get back to work. These experiences are already all too familiar for too many of us, and today marks a turning point in finding the solution.
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