Innovation in adult social care: can it be scaled up to improve more lives?

10 January 2018

There are some really good examples of innovative models of health, care and support for adults. The challenge now is to grow them; to scale up these primarily small-scale successes so that as many people’s lives are improved as possible. The recently-announced green paper on care and support will look at funding issues but it will also focus on the wider questions of providing high quality, community-orientated and sustainable social care.

A new report published today looks at how to achieve person-centred and community-centred ways of working across the care system; not just in pockets and for a small number of people, but across the whole of England and beyond. The report is published by the Social Care Institute for Excellence and partners Nesta, Shared Lives Plus and PPL Consulting.

Key messages

The report’s key messages include:

  • Innovation is needed more than ever as challenges and demand grows
  • Lots of good innovation already exists, the main challenge is finding ways to bring proven models of care to scale
  • Innovation does not only mean technological breakthroughs or large restructures. New and better ways of delivering relationship-based care exist, but are inconsistently implemented or often poorly scaled
  • For innovation to flourish, care and support services need to find better ways to help people bring good ideas from the margins into core business.

Life stories from the research

The report looks at a number of scenarios where small innovative approaches, if scaled-up, would improve many more people's lives; from helping people to say well, connected to others and resilient, to enabling people to enjoy their day doing meaningful things.

Andrew’s story

The report discusses a scenario where Andrew, aged 66 and recently retired, is missing his wife who died two years ago. He has become isolated and has started drinking heavily. His GP finds him a local area coordinator and a peer support network. The former identifies how he can be supported, through wider connections in the community, to live a good life. . The latter helps him reduce his drinking. He soon becomes a volunteer for his local football team. Then Andrew has a fall and there’s a danger he will revert back to his old situation. But he’s supported through his recovery by a micro-enterprise who provide home care. A buddy walking group get him moving about and before you know it Andrew’s volunteering helping older people. On two occasions, Andrew’s situation has been prevented from deteriorating because of community-based interventions, improving Andrew’s life and saving on valuable acute resources.

Opportunities and challenges

The report says that, for innovation to work, the keys to success include: a shared ambition to embed person-centred and community-centred ways of working across the system; using the best-available tools and evidence; and co-production – that is, planning with the people who have the greatest stake in services from the beginning. The report also looks at challenges that might compromise scaling up, including financial pressures, lack of strategic planning and leadership issues.

SCIE’s chief executive, Tony Hunter, says:

We all share a vision of a sustainable, high-quality and person-centred health and care system. That’s to be welcomed and encouraged but, for it to happen, we need to scale up what works. There are some great examples of innovation but all-too-often they’re reliant on short-term funding. We need braver decisions about how local resources are spent, with money being transferred over time from low-quality, low-outcome services to larger-scale impactful innovative models of care.

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