Social care, working with health, can provide many of the solutions to the challenges we face

By SCIE’s Ewan King, Director of Business Development and Delivery

Featured article – 11 June 2015

Image of Ewan King

Yesterday, SCIE’s chief executive Tony Hunter and I spoke about the role of social care in integrated care at the medical summit. When I first received the invite for this, I confess I was a little intimidated. Over 80 medical leaders and we had 40 minutes to impress on them the importance of social care; not an easy task!

But it was clear the moment we arrived at the medical leaders’ summit, chaired by Sir Bruce Keogh, NHS England’s National Medical Director, that we are reaching a point when the medical profession, and many of those charged with delivering the Five Year Forward View, understand that the NHS can no longer prosper on its own. It needs a vibrant, reformed, social care.

And this was the thrust of our speech. Yes, social care faces dire financial circumstances and the levels of underinvestment in the sector are reaching worrying levels. As the new President of ADASS, Ray James says: “Short-changing social care is short-sighted and short-term.” But it is also true that social care can – when it works closely with health – keep people independent and well for longer in their homes and communities. The NHS needs good social care to deliver good medical care. We have a real opportunity right now to find better ways to deliver shared objectives, pool our finite resources, and deliver better outcomes for people.

In the speech we talked about how four reforms taking place in social care – some longstanding, some newer – provide some of the answers to the question: How do we keep more people well and independent and out of hospital? First up was prevention and early intervention. There are a growing number of examples of innovative, integrated preventative services – some of which we showcase in our Prevention Library - which are harnessing the capacity, skills and networks of local people so that they can better look after themselves and others. And they are saving the NHS real money. 

The second area was coproduction, which is in danger – at least in parts of the NHS – as being seen as another form of consultation or engagement. It is not. Co-production – with its focus on meaningfully involving people in the design and delivery of services - holds the potentially to radically reshape services for the better.

The third area was personalisation, an area – and we made this point strongly – that Local government has been working on for many years. We told the story of Daniel – a mental health service user who has been in an out of inpatient care for years used a personal budget to purchase a package of care – including gym membership – to rebuild his life and improve his wellbeing.

Fourth, and finally, we talked about system leadership. It was not really for us to lecture this audience on the different models of leadership. But we did suggest, at least from a social care perspective, that traditional models of command and control leadership are increasingly insufficient for tackling some of the knotty, intractable, problems we face. Instead, we argued that there is an increasing need to focus on systems leadership – a model of leadership which focuses on leading across organisations and negotiating common solutions to the challenges we face.

The medical profession in the room treated us warmly and appeared very engaged in what we had to say. The harder task, as it is for all of us, is to make our commitments to shared working stick. To do this we need to constantly revisit why we are in the caring professions – what brought us here in the first place. For instance, by treating people when they are unwell and supporting them to get better. If we focus on those outcomes, many of the challenges we face can be overcome.


The five year forward view

SCIE resources and consultancy services to support integrated care

SCIE’s Prevention Library